Evaluation of Beta-Blockers as Triggers for Drug-Induced Lichen Planus in Hypertensive Patients

Author(s): Tasnuva Ashraf, Ayesha Siddika, Papia Heven, Humaira Afreen, Dilruba Aktar

Introduction: Lichen planus (LP) is a chronic inflammatory skin condition that can also affect mucosal surfaces, presenting as a variety of forms including oral, cutaneous, genital, and mixed types. The exact cause of LP remains unclear, but it is often associated with immune system dysfunction, genetic predisposition, and environmental triggers, including certain medications. This study aimed to evaluate the impact of beta-blockers as triggers for drug-induced lichen planus in hypertensive patients.

Methods: The retrospective cross-sectional study was conducted to evaluate the association between beta-blockers and drug-induced lichen planus (DILP) in patients with hypertension. The study took place in the Department of Dermatology Dhaka Medical College Hospital, Mainamoti medical college Hospital, Cumilla, outdoor,250 Bed Hospital, Moulovibazar. A total of 200 patients were selected as study subjects. Medical records of hypertensive patients diagnosed with lichen planus from January 2018 to December 2023 were reviewed. A significance level of p<0.05 was set to determine statistical significance. Statistical analyses were conducted using SPSS version 27.0.

Result: The study found significant associations between beta-blocker use and the onset of lichen planus (LP) in hypertensive patients. The prevalence of LP was higher in patients using beta-blockers for extended periods, particularly those on therapy for 3-4 years. The severity of LP also increased with the duration of beta-blocker use. Additionally, beta-blocker use was more common among those with oral and mixed-type LP, and comorbidities such as diabetes and asthma were more prevalent in beta-blocker users.

Conclusion: This study identifies a significant link between long-term beta-blocker use and the onset of drug-induced lichen planus (LP) in hypertensive patients, particularly after 3-4 years of therapy. The findings highlight the potential immunomodulatory effects of beta-blockers in triggering LP, emphasizing the need for careful monitoring and early intervention in patients on prolonged beta-blocker treatment.