Multiple autoimmune syndrome with isotopic phenomenon: Association of lichen planus, vitiligo and alopecia areata with autoimmune hepatitis

Multiple autoimmune syndrome (MAS) is the presence of 3 or more autoimmune disorders in the same patient, and is being increasingly reported. Here, we report a 31-year-old man who presented with lichen planus, vitiligo, alopecia areata and hepatitis. He also displayed isotopic phenomenon in the form of depigmented lichen planus lesions. Autoimmune tautology is implicated as the basis for MAS, and is supported by the findings of polyautoimmunity and familial immunity in cross-sectional studies. There are reports of dermatological and systemic autoimmune diseases co-occurring as MAS.