Lichen sclerosus in adult men: a study of HLA associations and susceptibility to autoimmune disease

Lichen sclerosus is a skin disorder of unknown prevalence affecting both me n and women, and several studies have established HLA associations in women with this disease, Autoimmune disease associations in the form of a person al and/or family history of autoimmune disease have also been shown to be r elated to lichen sclerosus, In this study, we examined 58 men (mean age 38 years) with lichen sclerosus, 39 of whom had histologically proven disease. HLA tissue typing by phototyping was performed on these patients and contr asted with that of 602 control subjects. There was no difference in antigen frequencies of the HLA class I loci. The patient group was found to have a n increased frequency of several HLA antigens of the class II loci: DR11, 1 3 of 58 (22%) patients vs. 75 of 602 (13%) control subjects (P = 0.05); DR1 2, five of 58 (9%) patients vs. 16 of 602 (3%) control subjects (P = 0.04); DQ7, 26 of 58 (45%) patients vs. 189 of 602 (31%) control subjects (P = 0. 05). There were few autoimmune disease associations: two of 58 (3%) patient s had a personal history of a different autoimmune disease, two patients we re found to have abnormal thyroid function and six of 58 (10%) had a first- degree relative with an autoimmune disease. There was no difference in the frequency of the autoimmune haplotype HLA Al, B8, DR3/17, DQ2 compared with the control population. HLA DQ7 has now been shown to occur more frequentl y in both male and female patients with lichen sclerosus, which may reflect the immunopathogenesis of the disease. Autoimmune disease associations, ho wever, are less common in men with lichen sclerosus.