title: Lichen planus and hepatitis virus infections: causal association?
abstract: BACKGROUND
  The causal association between hepatitis virus infections and lichen planus (LP) remains a matter of controversy. Reliable figures for German patients are still lacking.
  
  
  METHODS
  We analyzed the prevalence of serum antibodies against hepatitis B and C viruses (HBV, HCV) in 265 LP patients and compared the results to 257 patients with chronic urticaria (URT) and 222 patients with malignant melanoma (MM). Additionally, we analyzed age- and sex-specific differences.
  
  
  RESULTS
  The prevalence of HBV (13.2 % or 14.7 %) antibodies was significantly higher in patients with LP and URT patients than in the MM control group (HBV: 5.4 %, p < 0.001). The prevalence of HCV antibodies among LP and URT patients (2.6 % or 0.8 %) was not significantly greater (p > 0.05) than in MM patients (0.4 %). The prevalences of HBV and HCV in the MM control group were comparable to those in the general German population (HBV: 5-8 %, HCV: 0.4-0.7 %). An analysis by sub-groups showed that these differences resulted from sex- and age-dependent prevalences. HBV antibodies were significantly more common only in male LP patients (16.1 %) and in male (20.0 %) and female URT patients (15.6 %) aged 31-60 years. The greater prevalence of HCV in female LP patients older than 60 years of age was not significant.
  
  
  CONCLUSIONS
  LP is not specifically associated with hepatitis B or C antibodies in the Caucasian population of Germany. The higher prevalences of HBV antibodies found in LP and URT patients may be a reflection of age- and sex-related factors rather than disease-specific exposure to HBV infections. The increased prevalences seen in patients with LP or URT compared to MM patients may suggest that HBV infection serves as an unspecific trigger for a specific immune reaction of another origin.
authors.affiliation: Clinic and Polyclinic for Dermatology and Allergology, Ludwig-Maximilian-University of Munich, Germany. katharina.ruebsam@med.uni-muenchen.de
authors.forename: Katharina
authors.initials: K
authors.lastname: Rübsam
authors.forename: Andreas
authors.initials: A
authors.lastname: Schroll
authors.forename: Peter
authors.initials: P
authors.lastname: Weisenseel
authors.forename: Susanne
authors.initials: S
authors.lastname: Multhaup
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.forename: Jörg C
authors.initials: JC
authors.lastname: Prinz
mesh_terms: D000328:Adult; D015984:Causality; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008010:Lichen Planus / Q000453:epidemiology*; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D014581:Urticaria / Q000453:epidemiology*