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. 2025 Nov 28:18:3203-3211.
doi: 10.2147/CCID.S560840. eCollection 2025.

Clinicopathological Characteristics of Lichenoid Drug Eruption: A 17-Year Retrospective Study

Pichamon Promsena  1   2 , Wimolsiri Iamsumang  1 , Suthinee Rutnin  1
Affiliations

Clinicopathological Characteristics of Lichenoid Drug Eruption: A 17-Year Retrospective Study

Pichamon Promsena et al. Clin Cosmet Investig Dermatol. .

Abstract

Purpose: This study aims to characterize the etiology, clinicopathological features, laboratory findings, management strategies, and clinical outcomes of patients diagnosed with lichenoid drug eruption (LDE).

Patients and methods: A retrospective review was conducted on all biopsy-confirmed LDE cases from January 2008 to October 2024. Data collection included clinical characteristics, causative medications, histopathological as well as laboratory findings, and therapeutic responses.

Results: Of the 34 patients, half were male, with a mean age of 65.1 years. LDE most commonly presented as erythematous to violaceous lesions, appearing as patches and plaques, predominantly on the extremities. Histopathology showed lichenoid infiltrates in all cases, with focal infiltration in 58.8%. Parakeratosis was present in 17.7%. Necrotic keratinocytes were found in the basal layer in 82.4% and in the spinous layer in 38.2% of cases. Eosinophilic infiltration was observed in approximately one-third of patients. The most common offending agents were calcium channel blockers (CCBs) (42.5%), followed by statins (25.8%). The median latency period from drug initiation to symptom onset was 10.1 months (interquartile range [IQR] 3.0-45.5). Discontinuation of the causative agent combined with topical corticosteroid therapy resulted in clinical improvement in 73.5% of patients, with a median resolution time of 56 days (IQR 28.0-77.0).

Conclusion: Antihypertensive drugs, especially CCBs, were the most frequently implicated triggers of LDE. In addition to lichenoid dermatitis, eosinophilic infiltration served as a key histopathological hallmark of this condition. Timely identification and withdrawal of the causative medication, combined with appropriate treatment, are essential for achieving favorable clinical outcomes.

Keywords: adverse drug reactions; calcium channel blockers; drug eruption; histopathology; lichen planus; lichenoid dermatitis.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Clinical feature of lichenoid drug eruption: multiple greyish patches localized on the lower extremities.
Figure 2
Figure 2
Histopathology of lichenoid drug eruption: focal lichenoid infiltrate of mainly lymphocytes admixed with eosinophils in associated with scattered basal necrotic keratinocytes and focal parakeratosis (Hematoxylin and Eosin stain, x400).
Figure 3
Figure 3
Frequencies of causative drugs associated with lichenoid drug eruption.
See this image and copyright information in PMC

References

    1. Bhanja DB, Sil A, Maiti A, Biswas SK. Clinical profile of patients with lichenoid drug eruption: a observational study. Int J Dermatol. 2024;69:137–144. - PMC - PubMed
    1. Kim J, Muskaan S, Mufti A, Lytvyn Y, Maliyar K, Yeung J. Lichenoid drug eruptions associated with the use of biologic therapy: a systematic review. J Cutaneous Med Surg. 2022;26(5):521–522. doi: 10.1177/12034754221100188 - DOI - PubMed
    1. Halevy S, Shai A. Lichenoid drug eruptions. J Am Acad Dermatol. 1993;29:249–255. doi: 10.1016/0190-9622(93)70176-T - DOI - PubMed
    1. Masterson WM, Brown AM, Al Ameri MA, Patel AB. A retrospective chart review of management strategies for lichenoid eruptions associated with immune-checkpoint inhibitor therapy from a single institution. Cancer Treat Res Commun. 2022;30:100506. doi: 10.1016/j.ctarc.2021.100506 - DOI - PubMed
    1. Mual JT, Guillet C, Oschmann A, et al. Cutaneous lichenoid drug eruptions: a narrative review evaluating demographics, clinical features and culprit medications. J Eur Acad Dermatol Venereol. 2023;37(5):965–975. doi: 10.1111/jdv.18879 - DOI - PubMed

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