Rare Case Report Highlights Coexistence of Celiac Disease and Lichen Planus

These findings of the case report are published in the Indian Journal of Dermatology in 2026 by Dr. Naveen Kumar Kansal and colleagues from the All India Institute of Medical Sciences located in Rishikesh, India.

The specific medical case holds substantial importance for everyday clinical practice because it underscores the critical necessity of screening patients presenting with severe dermatological eruptions for underlying, potentially silent gastrointestinal autoimmune disorders. Identifying such hidden systemic conditions is absolutely vital, as undiagnosed CD can quietly predispose susceptible individuals to an array of secondary autoimmune diseases, ultimately complicating their overall clinical management.

A twenty-four-year-old female patient initially presented with chronic diarrhea, profound fatigue, a severely low body weight, and severe anemia, which subsequently prompted a duodenal biopsy that definitively confirmed the presence of CD. As she also exhibited itchy violaceous skin plaques, severe nail dystrophy, and painful gingival erosions, a subsequent skin biopsy verified widespread LP, prompting doctors to prescribe a strict gluten-free diet alongside systemic corticosteroids, topical immunomodulators, and oral antihistamines; unfortunately, the patient subsequently failed to return for her scheduled outpatient clinical monitoring.

Researchers propose that a shared autoimmune pathophysiology heavily driven by abnormal T-cell responses and elevated inflammatory cytokines, such as interferon-gamma and tumor necrosis factor-alpha, firmly links these two seemingly disparate medical conditions. Furthermore, the gut-skin axis theory suggests that elevated intestinal permeability resulting from active CD allows immune-activating peptides to translocate systemically, potentially triggering an immune cross-reaction against mucosal and cutaneous antigens in genetically vulnerable individuals.

For practicing clinicians, maintaining a high index of suspicion regarding this rare overlap is paramount because promptly recognizing the underlying gluten enteropathy can drastically optimize therapeutic interventions and completely alter the patient's long-term prognosis. Consequently, expanding our current understanding of this complex pathophysiological connection will directly enhance comprehensive patient care and strongly guide future clinical research into targeted, dual-action immunotherapies.

Reference

Kansal NK, Bhatia R, Kumar A, Gurumayum C, Sushantika, Gupta R. Eruptive and oral lichen planus in a female with celiac disease- A rare association. Indian J Dermatol 0;0:0