Lichen Planus

Last reviewed by Dr.Mary on October 4th, 2018.

What is Lichen Planus?

Lichen Planus is a condition which is inflammatory and that usually affects the mucous membranes as well as the skin.


Concerning the skin, the condition normally develops as often itchy, purplish, flat-topped lesions or bumps. With the mucous membranes, for example, tissues in the vagina or mouth – lichen planus develops as white lacy sores or patches which are painful.

Lichen planus is not contagious so it can not be passed between individuals. This disorder develops when the immunity system develops an assault against skin or mucous membrane cells. The reason for an immune response which is abnormal is not known.

A case of lichen planus which is mild only needs very trouble-free home care or no type of treatment at all. When symptoms develop which are severe like significant itching or pain, treatments can include drugs which suppress the abnormalities of the immune system.

Symptoms of Lichen Planus

Symptoms and signs of this condition differ depending on the body parts which are affected. This disorder very rarely gets worse following the first several months; however, the symptoms can continue for several months or even many years.

Skin

An individual can develop lichen planus on the skin, and they can have the following symptoms or signs:

  • Flat-topped, purplish bumps can develop at any area on the body, but most commonly situated on the inner forearm as well as near the ankles or wrists. Some other common areas include the neck, lower back as well as the legs.
  • Bumps usually appear in lines along the furrows in the skin, as well as groups or along the region of a scratch or some other injury.
  • Affected skin area is very itchy
  • Very rarely, these lesions become scaly, blistery or crusty
  • Lesions will rarely leave scars except if they are deeply scratched
  • When these lesions do vanish, the skin can have a dark brown discoloration which will eventually fade.

Mouth

When this problem involves the mouth which is known as oral lichen planus, the symptoms can consist of the following:

  • Areas of white lacy lines or dots which are white appear most frequently on the inside of the cheeks. The lips, tongue as well as the gums also can be involved.
  • Ulcers or sores can also develop in the mouth. They cause burning sensations as well as pain.

Genitals

This condition can affect the genitals but is less likely in men.

Men – Itching and purplish lesions of the skin often develop on the penis tip.
Women – Lesions as well as itching develop on the external genitalia or vulva or burning, painful lesions on the mucous membrane which lines the vagina. Some scarring can be possible, but are usually not common, following the mucous membranes as well as the skin healing.

Scalp

This condition can affect the scalp but is relatively uncommon. The name given for this problem is lichen planopilaris. Any lesions can result in:

  • Permanent or temporary hair loss
  • Discoloration or scarring in the scalp following healing

Nails

Even though lichen planus very rarely affects nails, causing the development of the following dilemmas involving 1 or more nails of the toes or fingers:

  • Ridges running the length of the nail
  • Splitting or thinning of the actual nail
  • Permanent or temporary nail loss

If a rash-like condition or tiny bumps develop on the skin for no obvious reason, for example, due to an allergic response or making contact with poison ivy, it is necessary to see your family physician. An individual should also see the physician if they experience any symptoms or signs linked with lichen planus of the genitals, scalp, mouth, or nails. Since there are numerous mucosal as well as skin conditions that can develop discomfort as well as pain, it is best to obtain an accurate as well as a prompt diagnosis.

What are the Causes of Lichen Planus?

The causes of lichen planus are not known. The lesions which develop are because of inflammation which is managed by specific white blood cells known as T lymphocytes. Usually, these white blood cells are activated at the site of the injury or disease. Physicians and scientists do not understand what prompts T lymphocytes to be triggered with this condition. But, there certain medical conditions, infections as well as other factors which can act as triggers of this inflammatory disorder in many individuals.

Factors which can act as triggers for lichen planus include:

  • Certain sorts of vaccines for the flu
  • Hepatitis C infection
  • Vaccine for hepatitis B
  • Allergy-causing substances
  • Pigments used in tattoos
  • Medications such as ibuprofen as well as naproxen which are nonsteroidal anti-inflammatory drugs
  • Some drugs which are given for heart problems, arthritis as well as blood pressure which is high

How to Treat Lichen Planus?

Following are some treatments for lichen planus:

Corticosteroids

These can help in reducing inflammation.
Topical – Long-term use of these can cause the skin to become thin, can suppress functions of the adrenal gland, lessening the effects of treatment as well as other problems with the skin.
Oral – Long-term use can weaken the bones, diabetes, high blood pressure, high cholesterol as well as other serious side effects.
Injections – Can be administered directly in the muscle tissue or the lesions. Repeated use often causes some of the same side effects as oral corticosteroids.

Retinoids

Synthetic versions of A vitamin can be applied topically or taken orally. Topical treatment can irritate the mucous membranes or skin. Should not be used by pregnant women or those planning to get pregnant.

Nonsteroidal ointments or creams

These medications have results which are related to or identical to oral medication. There are many such topical medications as well.

Antihistamine

Antihistamine acts against histamine which is involved in the inflammatory activity. An oral or topical antihistamine can relieve itching as well as pain

Phototherapy

This is light therapy and may help clear up this condition that affects the skin

UVB

This is the most common phototherapy using ultraviolet B light. This light can penetrate only the upper layer of skin.

UVA

Another type of therapy uses ultraviolet A light which penetrates deeply into the skin. This is normally used in combination with the oral or topical drug which makes the skin more sensitive to UVA light. Short-term side effects can include headache, itching as well as nausea.

Addressing triggers

If it is suspected that lichen planus is related to hepatitis c infection, an allergen, or drug you are taking, your physician may recommend steps to address this trigger. These can include:
Drugs – Stop taking the drug or use an alternative medication
Hepatitis C – Reference to a specialist for further diagnostic evaluation as well as disease management
Allergen – You will need to avoid this allergen and may need to see an allergist for additional treatment.

Lichen Planus Pictures

Pictures of Lichen Planus lichen planus on hands Lichen Planus on hands Lichen Planus on legs Lichen Planus on skin Lichen Planus on tongue

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