Abstract
OBJECTIVE: In some diseases associated with inflammation, the C-reactive protein-to-albumin ratio can be used as a biomarker of inflammation. Since lichen planus is a chronic inflammatory disease, our study aimed to investigate the relationship between C-reactive protein-to-albumin ratio and disease activity and whether it plays a role in determining disease prognosis, and compare them with those in subjects without lichen planus. METHODS: This is a case-control study. Demographic data, clinical features, and laboratory measures, including neutrophil, lymphocyte, eosinophil, platelet counts, neutrophile-to-lymphocyte ratio, erythrocyte sedimentation rate, C-reactive protein, albumin, and C-reactive protein-to-albumin ratio were statistically compared between patients with lichen planus (n=61) and controls (n=64). RESULTS: Albumin and erythrocyte sedimentation rate (p<0.001), C-reactive protein (p=0.017), C-reactive protein-to-albumin ratio (p=0.016), and neutrophile-to-lymphocyte ratio (p=0.02) were significantly higher in the patient group than in the control group. C-reactive protein-to-albumin ratio (p=0.003, OR 1.2), neutrophile-to-lymphocyte ratio (p=0.02, OR 1.4), and erythrocyte sedimentation rate (p=0.003, OR 1.1) were effective in differentiating patients from the healthy group. Erythrocyte sedimentation rate>4.5 mm/h, C-reactive protein-to-albumin ratio>0.6, and neutrophile-to-lymphocyte ratio>1 were useful in showing disease activity, of which C-reactive protein-to-albumin ratio has the best value with 92% sensitivity. C-reactive protein-to-albumin ratio has a sensitivity of 100% and is more effective and sensitive than other markers in distinguishing between mild and severe groups and between single and multiple involvement. CONCLUSION: Elevated C-reactive protein-to-albumin ratio levels may be considered a potential marker for lichen planus. It may be highly sensitive to follow-up of systemic inflammation and disease activity in patients with lichen planus. However, further prospective studies may confirm the association between C-reactive protein-to-albumin ratio and lichen planus.