article · World Journal of Advanced Research and Reviews
A clinical study evaluated the link between thyroid dysfunction and specific subtypes of lichen disorders in a cohort of 302 patients in Morocco. Overall, thyroid dysfunction was present in 14.6 percent of the participants, with hypothyroidism being the most common condition, followed by hyperthyroidism and isolated autoimmune thyroiditis. The analysis revealed that frontal fibrosing alopecia was significantly linked to higher rates of thyroid dysfunction, particularly driven by an increased rate of hyperthyroidism. Conversely, lichen planus pigmentosus showed a significantly lower prevalence of hypothyroidism. Furthermore, the presence of oral mucosal lesions was associated with more than double the likelihood of thyroid dysfunction. These findings indicate that thyroid comorbidity is phenotype-specific in lichen disorders, suggesting that targeted thyroid screening is particularly relevant for individuals diagnosed with frontal fibrosing alopecia or oral manifestations.
Lichen disorders are chronic inflammatory conditions affecting the skin, hair, and mucous membranes. Demonstrating that thyroid disorders occur unevenly across distinct clinical subtypes helps clinicians move beyond treating lichen conditions as a uniform group. Identifying high-risk presentations, such as frontal fibrosing alopecia or oral lesions, enables more targeted diagnostic evaluations, improving patient care and potentially leading to earlier detection of underlying metabolic issues.
The findings are clinical observations that could inform diagnostic screening guidelines and clinical decision support tools used by dermatologists and endocrinologists. The research remains at an early observational stage, offering evidence to support routine diagnostic blood panels for specific patient subsets rather than a direct commercial product. Any formal implementation into clinical protocols or digital triage software would require validation through larger prospective clinical trials.
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Background: Lichen disorders have been linked to thyroid dysfunction, but most studies treat them as a single entity, and data from North African populations with darker phototypes remain limited. Objective: To evaluate thyroid dysfunction prevalence across clinical subtypes of lichen disorders in a North African cohort. Methods: A cross-sectional study (retrospective and prospective, February 2023–February 2026) was conducted at CHU Ibn Sina, Rabat, Morocco, including 302 patients with confirmed lichen disorders. Thyroid dysfunction was defined as a previously diagnosed disorder or an abnormal thyroid assessment (TSH, FT4, anti-TPO, anti-Tg). Associations were assessed using Chi-square/Fisher’s exact tests and odds ratios (OR). Results: Mean age was 52 years (IQR: 43–62); 93.7% were female. Frontal fibrosing alopecia (FFA) was the most frequent subtype (42.4%), followed by lichen planus pigmentosus (LPP, 38.4%) and classical lichen planus (23.5%). Thyroid dysfunction occurred in 14.6% of patients: hypothyroidism (10.0%), hyperthyroidism (3.6%), and isolated autoimmune thyroiditis (2.3%). FFA was the only subtype significantly associated with thyroid dysfunction (20.3% vs. 10.3%; p = 0.024, OR = 2.2), driven by hyperthyroidism (8.6% vs. 0%; p < 0.001). LPP showed a significantly lower hypothyroidism prevalence (4.3%; p = 0.010, OR = 0.29). Oral mucosal involvement more than doubled thyroid dysfunction prevalence (27.3%; p = 0.028, OR = 2.51). Conclusion: Thyroid dysfunction is a significant, phenotype-specific comorbidity of lichen disorders. The novel FFA-hyperthyroidism association warrants confirmation in larger prospective studies, and supports systematic thyroid screening, particularly in patients with FFA or oral mucosal involvement.
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DOI: 10.30574/wjarr.2026.31.2.2047
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