Commentary - (2024) Volume 21, Issue 2
Received: 29-Feb-2024, Manuscript No. IPDEHC-24-19110; Editor assigned: 04-Mar-2024, Pre QC No. IPDEHC-24-19110 (PQ); Reviewed: 18-Mar-2024, QC No. IPDEHC-24-19110; Revised: 25-Mar-2024, Manuscript No. IPDEHC-24-19110 (R); Published: 01-Apr-2024, DOI: 10.35248/2049-5471-21.2.11
Lichen Planus (LP) is a chronic inflammatory condition that may affect the skin, nails, hair, and oral mucosa with a global estimated prevalence ranging from 0.5% to 1% [1]. The classic presentation involves flat-topped, violet papules on the skin, exhibiting various morphological variants; however, over 20 different clinical manifestations of LP are described [2]. LP manifests across all skin types, but preferentially affects middleaged adults, with no known gender predisposition. Although the disease is often self-limiting, the relentless pruritus and painful mucosal erosions cause significant morbidity. Additionally, LP patients are more likely to experience depression and reduced quality of life [3]. Diagnosing LP in Skin of Colour (SOC) populations poses challenges due to potential dermoscopic variations in this population. Notably, a lack of confidence has been reported in managing SOC populations [4]. Data on the racial and ethnic distribution of U.S. LP clinical trials are limited. Thus, we aim to assess the current demographic composition of U.S. LP clinical trials compared to 2022 U.S. Census data [5]. In November 2023, the authors searched the “https://clinicaltrials.gov” database using the following filters: Condition: Lichen Planus, Country: United States, Recruitment: Complete, Study Type: Interventional (Clinical Trial), Study Results: With Results. Of the 11 identified clinical trials, 9 met our inclusion criteria with a total of 341 participants (Table 1).
Table 1: Demographic makeup of United States lichen planus clinical trials
| Racial Representation of Lichen Planus Clinical Trials (n=341) | |||||||
|---|---|---|---|---|---|---|---|
| American Indian or Alaska Native | Asian | Native Hawaiian or other Pacific Islander | Black or African American | White | More than one race | Unknown or not reported | Other |
| 0.29% (1) | 2.35% (8) | 0.00% (0) | 8.78% (30) | 71.55% (244) | 0.00% (0) | 17.01% (58) | 0.00% (0) |
| Ethnic Representation of Lichen Planus Clinical Trials (n=341) | |||||||
| Hispanic or Latino | Not Hispanic or Latino | Unknown or not reported | |||||
| 7.62% (26) | 25.51% (87) | 66.86% (228) | |||||
Of the participants, 74.2% (n=253) identified as female and 25.8% (n=88) as male. Furthermore, 71.55% (n=244) of participants identified as White, 17.01% (n=58) as unknown or not reported, 2.35% (n=8) as Asian, 8.78% (n=30) as Black or African American, 0.29% (n=1) as American Indian or Alaska Native, 0% (n=0) as other, 0% (n=0) as more than one race, and 0% (n=0) as Native Hawaiian or Other Pacific Islander. Regarding ethnicity, 7.62% (n=26) of participants identified as Hispanic or Latino, 25.51% (n=87) as not Hispanic or Latino, and 166.86% (n=228) as unknown or not reported. As compared to census data, Black or AA (8.78% vs. 13.6%), Hispanic or Latino (7.62% vs. 19.1%), Asian (2.35% vs. 6.3%), American Indian or Alaska Native (0.29% vs. 1.3%), and Native Hawaiian or Other Pacific Islander (0.0% vs. 0.3%) groups were underrepresented. White (71.55% vs. 75.5%) was closely represented. Our study demonstrates the underrepresentation of multiple minority groups in LP clinical trials when compared to U.S. census data. This issue is particularly crucial due to the distinct variations in the “classic” clinical presentation of lichen planus across different skin complexions. The misalignment between trial demographics and the diverse population affected by LP highlights the potential for misdiagnoses or delayed diagnoses in SOC patients. Bridging this gap by increasing the diversity of clinical trial participants is crucial for developing comprehensive insights and tailored interventions that address the full spectrum of LP among all patients.
The data that support the findings of this study are openly available at https://clinicaltrials.gov/. Data will be shared upon inquiry.
The authors have no funding sources to disclose.
IRB approval was not required.
Not applicable.
The authors would like to thank the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery.
The authors have no financial or non-financial conflicts of interest to disclose.
[Crossref] [Google Scholar] [PubMed]
[Crossref] [Google Scholar] [PubMed]
[Crossref] [Google Scholar] [PubMed]
Citation: Pulumati A, Algarin YA, Hirsch M, Nouri K (2024) A Cross-sectional Analysis of Diversity in Lichen Planus Clinical Trials. Divers Equal Health Care. 21:11.
Copyright: © 2024 Pulumati A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
