Meta-Analysis Reveals Strong Association Between Lichen Sclerosus and Autoimmune Thyroid Disorders
Taiwan: A systematic review and meta-analysis published in the Indian Journal of Dermatology, Venereology and Leprology has revealed a significant association between lichen sclerosus (LS), a chronic inflammatory skin condition, and various thyroid disorders.
The research, led by Dr. Po-Chien Wu from the Department of Dermatology, Chang Gung Memorial Hospital, Linkou Main Branch, Taiwan, and colleagues, highlights the importance of monitoring thyroid health in patients with LS.
Lichen sclerosus is characterized by ivory-white patches or plaques on the skin, often affecting middle-aged women. Previous studies suggested an autoimmune component in LS, given its links with conditions like autoimmune thyroiditis, alopecia areata, and vitiligo. However, the strength and nature of its association with thyroid diseases had remained uncertain.
The review included nine case-control studies encompassing a total of 177,488 LS patients and over 22 million controls. Most participants were recruited from the USA, with additional data from Poland, Sweden, the UK, Finland, and Serbia. All studies were assessed for quality using the Newcastle–Ottawa Scale and scored seven or higher, indicating reliable selection, comparability, and exposure measures.
Key Findings:
- LS patients had higher odds of developing thyroid disease overall (OR 2.48).
- LS was associated with an increased risk of thyroiditis (OR 2.07).
- LS patients showed a higher likelihood of autoimmune thyroid disease (OR 4.07).
- LS was linked to autoimmune thyroiditis/Hashimoto thyroiditis (OR 2.97).
- LS patients had elevated odds of Graves’ disease (OR 2.34).
- Adjusted estimates showed increased risk of family history of thyroid disease in LS patients (aOR 9.10).
- LS patients had higher odds of hypothyroidism (aOR 1.91).
- Adjusted analyses confirmed increased risk of thyroiditis (aOR 2.00).
- LS was associated with an elevated risk of autoimmune thyroiditis/Hashimoto thyroiditis (aOR 2.88).
The findings suggest that LS patients, particularly those with autoimmune involvement, are more likely to develop thyroid disorders. Physicians are therefore encouraged to monitor LS patients for thyroid-related symptoms, such as palpitations, heat intolerance, and unexplained changes in body weight, and to consider early consultation with endocrinologists for timely diagnosis and management.
Despite the large patient population, the review had several limitations. Most studies were conducted in European populations, limiting generalizability. The number of studies included in quantitative analyses was relatively small, and subgroup analyses based on age, race, LS severity, or type were not possible due to limited data. Additionally, the potential impact of systemic treatments like steroids or immunosuppressants was not fully addressed, and variability in thyroid disease terminology across studies complicated comparisons.
The authors note the need for future research incorporating diverse populations, standardized definitions, long-term cohort designs, and consideration of systemic therapies.
"The systematic review and meta-analysis emphasize a clear link between lichen sclerosus and thyroid disorders, particularly thyroiditis and autoimmune thyroiditis/Hashimoto thyroiditis. The findings emphasize the importance of thyroid monitoring in LS patients and provide evidence for integrating endocrine evaluation into routine dermatological care," the authors concluded.
Reference:
Wu PC, Huang IH, Tai CC, Chi CC. Association between lichen sclerosus and thyroid diseases: A systematic review and meta-analysis. Indian J Dermatol Venereol Leprol. doi: 10.25259/IJDVL_54_2025
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