Evaluation of Serum Homocysteine Levels in Patients with Cutaneous-Oral Lichen Planus and Psoriasis Patients

  • Ghasem Rahmatpour Rokni
  • Fatemeh Heydari
  • Masoud Golpour
  • Jamshid Yazdani
  • Ali Morad Heidari Gorji Assistance Prof, Members faculty (EDC), Mazandaran University of Medical Science, Sari, Iran
Keywords: Homocysteine, Cutaneous Lichen Planus, Oral Lichen Planus, Psoriasis


Background: An elevated plasma homocysteine level is suggested to be a risk factor for reversible atherosclerotic cardiovascular disease. Psoriasis and lichen planus are two chronic inflammatory skin diseases associated with an increased risk of thrombosis and cardiovascular disease. Materials and Methods: We conducted this descriptive analytical study in 2015 on 30 psoriatic patients and 30 patients with cutaneous-oral lichen planus (selected via a simple randomized method) who were referred to the outpatient department of dermatology at Bouali Sina training and therapeutic hospital in Sari, Iran. We evaluated the serum homocysteine, vitamin B12, and folic acid levels in all patients. Data were evaluated using descriptive statistics and an independent t-test. Logistic regression was used for controlling confounding variables. Results: Nine (30%) patients in the psoriasis group and 11 (36.66%) in the cutaneous-oral lichen planus group had abnormally high blood homocysteine level (P = 0.001). Serum vitamin B12 level in the psoriatic group was significantly higher than in the cutaneous-oral lichen planus group (P = 0.034). Both mean and maximum serum folic acid levels in the psoriatic group were higher than in the cutaneous-oral lichen planus group, but the difference was not significant (P = 0.296). As psoriasis and cutaneous-oral lichen planus are chronic inflammatory skin diseases, in these groups, the serum homocysteine levels were higher than in healthy control subjects, but there was no significant differences between the two groups. Conclusion: Further studies are recommended about the course of treatment in patients with psoriasis and lichen planus diseases before therapeutic intervention. [GMJ.2017;6(3):226-232] DOI: 10.22086/gmj.v0i0.749


Arias-Santiago S, Buendia-Eisman A, Aneiros-Fernandez J, Giron-Prieto MS, Gutierrez-Salmeron MT, Mellado VG, et al. Cardiovascular risk factors in patients with lichen planus. Am J Med. 2011;124(6):543-8.

Sommer DM, Jenisch S, Suchan M, Christophers E, Weichenthal M. Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis. Arch Dermatol Res. 2006;298(7):321-8.

Severi G, Sinclair R, Hopper JL, English DR, McCredie MR, Boyle P, et al. Androgenetic alopecia in men aged 40-69 years: prevalence and risk factors. Br J Dermatol. 2003;149(6):1207-13.

Dreiher J, Shapiro J, Cohen AD. Lichen planus and dyslipidaemia: a case-control study. Br J Dermatol. 2009;161(3):626-9.

Duman N, Ersoy Evans S, Atakan N. Rosacea and cardiovascular risk factors: a case control study. J Eur Acad Dermatol Venereol. 2014;28(9):1165-9.

McDonald I, Connolly M, Tobin AM. A review of psoriasis, a known risk factor for cardiovascular disease and its impact on folate and homocysteine metabolism. J Nutr Metab. 2012;2012:965385.

Chang JY, Wang YP, Wu YC, Cheng SJ, Chen HM, Sun A. Hematinic deficiencies and pernicious anemia in oral mucosal disease patients with macrocytosis. J Formos Med Assoc. 2015;114(8):736-41.

Lentz SR. Mechanisms of homocysteine-induced atherothrombosis. J Thromb Haemost. 2005;3(8):1646-54.

Ganguly P, Alam SF. Role of homocysteine in the development of cardiovascular disease. Nutr J. 2015;14:6.

Graham IM, Daly LE, Refsum HM, Robinson K, Brattstrom LE, Ueland PM, et al. Plasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project. Jama. 1997;277(22):1775-81.

Erturan İ, Köroğlu BK, Adiloğlu A, Ceyhan AM, Akkaya VB, Tamer N, et al. Evaluation of serum sCD40L and homocysteine levels with subclinical atherosclerosis indicators in patients with psoriasis: a pilot study. Int J Dermatol. 2014;53(4):503-9.

Sharma A, Bialynicki-Birula R, Schwartz RA, Janniger CK. Lichen planus: an update and review. Cutis. 2012;90(1):17-23.

Rajendam R. Shafer’s text book of oral pathology. Elsevier Indian; 2009.

Edwards PC, Kelsch R. Oral lichen planus: clinical presentation and management. J Can Dent Assoc. 2002;68(8):494-9.

Chen HM, Wang YP, Chang JY, Wu YC, Cheng SJ, Sun A. Significant association of deficiencies of hemoglobin, iron, folic acid, and vitamin B12 and high homocysteine level with oral lichen planus. J Formos Med Assoc. 2015;114(2):124-9.

Saleh N, Samir N, Megahed H, Farid E. Homocysteine and other cardiovascular risk factors in patients with lichen planus. J Eur Acad Dermatol Venereol. 2014;28(11):1507-13.

Sun A, Lin HP, Wang YP, Chiang CP. Significant association of deficiency of hemoglobin, iron and vitamin B12, high homocysteine level, and gastric parietal cell antibody positivity with atrophic glossitis. J Oral Pathol Med. 2012;41(6):500-4.

Brazzelli V, Grasso V, Fornara L, Moggio E, Gamba G, Villani S, et al. Homocysteine, vitamin B12 and folic acid levels in psoriatic patients and correlation with disease severity. Int J Immunopathol Pharmacol. 2010;23(3):911-6.

Malerba M, Gisondi P, Radaeli A, Sala R, Calzavara Pinton PG, Girolomoni G. Plasma homocysteine and folate levels in patients with chronic plaque psoriasis. Br J Dermatol. 2006;155(6):1165-9.

Tobin AM, Hughes R, Hand EB, Leong T, Graham IM, Kirby B. Homocysteine status and cardiovascular risk factors in patients with psoriasis: a case-control study. Clin Exp Dermatol. 2011;36(1):19-23.

Azizi, Alavizadeh P, Sadri D, Lesan S. Evaluation of serum levels of vitamin B12 in patients with lichen planus. Journal of Isfahan Dental School. 2013;8(7):616-21

How to Cite
Rahmatpour Rokni, G., Heydari, F., Golpour, M., Yazdani, J., & Heidari Gorji, A. M. (2017). Evaluation of Serum Homocysteine Levels in Patients with Cutaneous-Oral Lichen Planus and Psoriasis Patients. Galen Medical Journal, 6(3), 226-232. https://doi.org/10.31661/gmj.v6i3.749
Original Article