Lichen planus is a type of inflammation that can affect the skin, hair, nails, and mucous membranes. On the skin, lichen planus usually appears as purplish, itchy, flat bumps that can develop over several weeks. In the mouth, vagina, and other areas covered by a mucous membrane, lichen planus forms lacy white patches, sometimes with painful sores.

While it’s not dangerous, it can cause considerable discomfort. The cause of lichen planus is unknown, but it’s often associated with the immune system’s response to inflammation. Some people might get lichen planus in reaction to certain medications, chemicals and infections.

Lichen Planus

It is most commonly found in middle-aged adults, and it is rare in children. There is currently no known cure, but there are treatments available to help manage symptoms. It’s also worth noting that, in most cases, lichen planus is not contagious.

Causes of Lichen planus

Lichen planus is a non-infectious, inflammatory skin condition that can affect various parts of the body. The exact cause of lichen planus is not clearly known, however, it is believed to be related to an immune system response triggered by certain factors. These include:

1. Hepatitis C Infection: In some cases, lichen planus has been connected to hepatitis C infections.

2. Allergic Reaction: Some people may develop lichen planus as a result of an allergic reaction to certain medications, dyes, metals, or chemicals.

3. Genetic Factors: Individuals with a family history of lichen planus are more likely to develop the condition.

4. Immune System Disorders: Lichen planus may also be related to disorders where the body’s immune system mistakenly attacks its own cells.

5. Stress: High levels of stress may trigger lichen planus or make its symptoms worse.

6. Certain medications: Certain drugs, such as those for heart disease, high blood pressure or arthritis, may also trigger lichen planus.

It’s important to note that this disease is not contagious and cannot be passed from one person to another. If one has any symptoms or concerns, they should consult with a healthcare professional for a diagnosis and advice on managing symptoms.

Risk Factors of Lichen planus

Lichen planus is an inflammatory condition that can affect the skin, hair, nails, and mucous membranes. Although the exact cause remains unknown, several risk factors might contribute to the development or exacerbation of this condition.

1. Genetics: Lichen planus can sometimes run in families, suggesting a genetic predisposition.

2. Autoimmune disorders: People with certain autoimmune diseases, such as lupus or rheumatoid arthritis, may be more likely to develop lichen planus.

3. Stress: While not a direct cause, there may be a link between periods of high stress and onset or worsening of lichen planus symptoms.

4. Infections: Hepatitis C infection has been correlated with a higher prevalence of lichen planus.

5. Certain medications: Some drugs, including those used for heart disease, high blood pressure or arthritis, can cause lichen planus or similar rashes.

6. Exposure to chemicals or metals: Lichen planus can be triggered by exposure to chemicals used in color film development, some medications, and metals such as gold and arsenic.

7. Vaccinations: In rare instances, lichen planus has developed in reaction to a hepatitis B or flu vaccine.

It’s also worth noting that while lichen planus can occur at any age, it’s often seen in middle-aged adults. It is seldom seen in children or elderly people. Additionally, some studies suggest it may occur slightly more frequently in women than in men.

Signs and Symptoms of Lichen planus

Lichen Planus is an inflammatory condition that can affect the skin, hair, nails and mucous membranes. The signs and symptoms include:

Skin:
1. Itchy skin rash: The rash often appears as shiny, flat bumps that are purple or reddish in color.
2. Lesions or bumps: These might form a line or a cluster.
3. Development over weeks to months: It can persist for months or even years and then disappear just as slowly. The skin might discolor after it heals.
4. Wickham’s Striae: These are fine, white lines that streak the lesions.

Mouth:
1. White patches in the mouth: These are well-defined patches or a network of raised, white lines on the inside of the cheeks, gums, or tongue.
2. Red, swollen, tender gums
3. Uncomfortable/painful sores

Scalp:
1. Redness
2. Hair loss

Nails:
1. Ridges, grooves or splitting of the nails
2. Damaged or lost nails

Genitals:
1. Redness and irritation
2. Erosive lichen planus can cause painful sores

In some cases, it affects the areas on the skin where it was previously injured or damaged. In general, most of the symptoms can cause discomfort, pain, or itching. As the symptoms can be similar to other diseases, one should consult a healthcare professional if any suspicious symptoms appear. Suppose signs persist after proper treatment or lead to severe discomfort. In that case, a consultation from a specialist might be required to exclude the possibility of malignancy.

Diagnosis Lichen planus

Lichen Planus is a condition that can cause swelling and irritation in the skin, hair, nails, and mucous membranes. While it’s usually found on the wrists, ankles, or lower back, it can also affect the mouth, genitalia, scalp, or nails.

The cause of lichen planus is unknown. It’s believed to be related to inflammatory responses by the body’s immune system. It is not contagious and cannot be passed from person to person.

Some common symptoms include purplish, itchy flat-topped bumps, rashes on the inner wrists, legs, torso, or genitals, hair loss, white patches in the mouth or on the lips, nail damage or loss, mouth pain, or a burning sensation in the mouth.

It’s important to seek medical advice if these symptoms arise, as they can also be indicative of other conditions. Diagnosis typically involves a physical examination, review of personal medical history, a skin biopsy, or allergy tests. Treatment can include antihistamines to reduce itching, corticosteroids to lessen inflammation and swelling, and other medications or therapies as needed.

However, many times, the condition resolves on its own without treatment. Mild cases, particularly those that do not cause significant discomfort or affect the person’s daily life, may not require any treatment. However, any symptoms that cause concern should be evaluated by a healthcare provider.

Treatment of Lichen planus

Lichen planus is a chronic inflammatory and immune mediated condition that affects the skin, nails, hair, and mucous membranes. While there’s no cure for lichen planus, treatment can help manage symptoms and relieve itching.

1. Topical Steroids: Typically as a first line treatment, corticosteroids may be recommended to reduce inflammation and alleviate itching. Topical steroids are usually applied directly to the affected areas of skin.

2. Oral Medications: Oral corticosteroids can be used for more severe cases or when lichen planus affects large areas of the body. These can have side effects and are usually used only for a short period.

3. Immunosuppressants: In cases where steroids are not effective, drugs that modify the immune system may be prescribed.

4. Antihistamines: These can help control itching.

5. Retinoids: Topical or oral retinoids can help, especially if lichen planus affects the scalp or is severe.

6. Photoforaphy(light therapy): Exposing the skin to controlled amounts of natural or artificial light can help.

7. Emollients: Regular use of moisturizing creams can help reduce itching and keep the skin moist.

Remember that treatment varies considerably depending upon the locations of the infection and the individual’s health situation. Therefore, it’s crucial to talk to your healthcare provider or dermatologist to discuss the most suitable treatment plan for your condition. It’s also important to note that lichen planus can take a long time to resolve, and even with treatment, complete healing may take several months. It may also recur.

Medications commonly used for Lichen planus

Lichen Planus is a condition that causes swelling and irritation in the skin, hair, nails, and mucous membranes. Depending on the severity and nature of the symptoms, several medications may be used for treatment:

1. Corticosteroids: These are typically the first choice for relieving inflammation and redness. They can be prescribed in different forms including creams, ointments, gel for the skin, and oral tablets for more severe cases.

2. Antihistamines: Both topical and oral antihistamines may be recommended to relieve itchiness associated with lichen planus.

3. Immune response medications: Medicines like tacrolimus ointment or pimecrolimus cream can help suppress the immune response leading to less inflammation.

4. Retinoids: These are often used for treating skin conditions. Topical products may be used for cutaneous lichen planus, while oral retinoids are usually reserved for more severe cases.

5. Light Therapy (Phototherapy): This isn’t a medication but might be recommended in combination with medications, usually for widespread lichen planus.

6. Nonsteroidal creams or ointments: Medicines like tacrolimus (Protopic) and pimecrolimus (Elidel) may be suggested for relieving itching and inflammation.

7. Antimalarial Drugs: Certain cases of lichen planus have been treated successfully with antimalarial drugs, like hydroxychloroquine.

Do note that the choice and type of treatment can vary widely depending on the individual’s condition, the severity of symptoms, the specific type of lichen planus, and other health factors. As such, you should always speak to a healthcare professional or doctor for advice on your specific case. This information should not replace a consultation with a medical professional.

Prevention of Lichen planus

Lichen Planus is a condition that can’t be prevented necessarily as the exact cause is unknown. However, once diagnosed, various steps can be followed to prevent its aggravation or recurrence:

1. Avoid Injury: In times of active disease, you should try to avoid any injuries. Also, known as Koebner response, there are chances that new lesions may form at the site of injury

2. Avoid Stress: Stress can worsen the condition, hence, stress-managing activities like yoga and meditation can be helpful.

3. Maintain Oral Hygiene: Poor dental hygiene may trigger oral lichen planus. Regular dental check-ups, teeth cleaning, flossing, and avoiding spicy or acidic food can help.

4. Avoid Allergens: If lichen planus is related to a specific allergy, avoid the allergen.

5. Medication: If Lichen Planus is caused as a reaction to certain medications, consult with your doctor to change those medications.

Remember, prevention measures can vary from person to person basis on their specific triggers and health background. It’s crucial to work with a healthcare professional to effectively prevent and manage the condition.

FAQ’s about Lichen planus

1. What is lichen planus?
Lichen planus is a condition that can cause swelling and irritation in the skin, hair, nails, and mucus membranes.

2. What causes lichen planus?
The exact cause is still unknown, but it’s often associated with an immune system response triggered by a variety of factors such as hepatitis C, certain medications, vaccines, or allergens.

3. What are the symptoms of lichen planus?
Symptoms include purple, itchy, flat bumps on the skin, lacy white patches in the mouth, hair loss, and nail damage.

4. Is lichen planus contagious?
No, lichen planus is not contagious. You cannot catch it from someone or give it to someone.

5. How is lichen planus diagnosed?
Doctors usually diagnose lichen planus by its appearance and sometimes confirm it with a skin biopsy.

6. What is the common treatment for lichen planus?
Common treatments include corticosteroids, retinoids, and immunosuppressants. Over-the-counter remedies can also help manage itching.

7. Is lichen planus a chronic condition?
The condition could be chronic and can flare up periodically, though there are also cases where it clears up on its own after a few years.

8. Can lichen planus be prevented?
There is no sure way to prevent lichen planus as the exact cause is unknown. However, managing stress and avoiding medications that have previously triggered the condition can help.

9. Can cosmetic products worsen the condition?
Certain substances like harsh soaps, dye, or other cosmetic products may irritate the skin and worsen the conditions of lichen planus. So it’s recommended to use mild and hypoallergenic products.

10. Does lichen planus increase the risk for other medical conditions?
Having oral lichen planus for a long time increases the risk of developing mouth cancer. Regular check-ups can help detect any abnormal changes early.

Useful links

Lichen planus is a chronic inflammatory and immune-mediated disease that affects the skin, nails, hair, and mucous membranes. It is characterized by polygonal, flat-topped, violaceous papules and plaques with overlying, reticulated, fine white scale (Wickham’s striae), commonly affecting dorsal hands, flexural wrists and ankles, the oral mucosa, and the genitalia.

Here are several useful links to journals and articles about lichen planus:

  1. https://pubmed.ncbi.nlm.nih.gov/34096678/
  2. https://pubmed.ncbi.nlm.nih.gov/30318136/

Each research paper features a different aspect of lichen planus from its pathogenesis to its management and treatment. Please note that articles from academic and professional sources may require a subscription or purchase to access the full text.

Complications of Lichen planus

Lichen planus is a condition that can cause swelling and irritation in the skin, hair, nails, and mucous membranes. While the exact cause of the disease is unknown, it is believed to be related to an autoimmune response. Although not usually a severe condition, lichen planus can lead to a number of complications.

1. Skin Discoloration: One of the most common complications of lichen planus is lingering patches of darker skin after the condition is under control. This can be particularly noticeable in people with darker skin tones.

2. Hair Loss and Scarring: If lichen planus affects the scalp, it can cause permanent hair loss and scarring.

Lichen Planus

3. Nail Damage: Lichen planus can cause ridges to form, as well as grooves and lines in the nails. In severe cases, the nails may shed altogether.

4. Dental Issues: If lichen planus affects the mucous membranes inside the mouth, it can lead to a number of dental issues. Painful sores may form which can hamper eating and brushing effectively. In the long-term, this can lead to cavities, gum disease and other oral issues.

5. Emotional distress/psychological impact: As a chronic, visible condition, it can significantly impact the self-esteem and mental health of sufferers. Anxiety and depression are common in people with chronic skin conditions such as lichen planus.

6. Lichen Planus and cancer: There are ongoing debates about whether there is a link with lichen planus (especially oral lichen planus) and an increased risk of cancer, specifically squamous cell carcinoma. Research is ongoing on this matter, but patients with oral lichen planus usually require regular monitoring for any cancerous changes.

Lichen planus is typically treated with corticosteroids, retinoids, antihistamines, or other immunosuppressant drugs. If the disease affects the mouth, it is important for individuals to practice good oral hygiene to reduce the risk of cavities or other complications.

Home remedies of Lichen planus

Lichen planus is a skin rash triggered by the immune system. It’s not fully understood what causes this abnormal immune response, but it’s often associated with hepatitis C infections, liver disease, certain flu vaccines, and a variety of other factors.

While professional medical treatment should be sought for more severe or persistent symptoms of lichen planus, some home remedies may aid in alleviating discomfort or itchiness associated with the condition:

1. Aloe Vera: Known for its healing properties, direct application of aloe vera gel on the affected area may soothe the skin.

2. Turmeric: Due to its anti-inflammatory properties, turmeric can be used by making a paste with water and applying it on the affected areas.

3. Coconut Oil: Rich in anti-inflammatory and healing properties, coconut oil can be applied on the skin rash for relief.

4. Cool Compress: This can help to bring relief from the constant itching and inflammation.

5. Oatmeal Bath: This is known to be soothing for skin conditions such as lichen planus. Just mix a cup of oatmeal in your bathwater and soak for 15-20 minutes.

6. Ginger: Ginger also possesses anti-inflammatory benefits. Crush or juice fresh ginger and apply it directly to the affected area for relief from symptoms.

7. Vitamin A and D: Taking over-the-counter vitamin A and D ointments can also help soothe and heal lichen planus.

It’s crucial to remember that these remedies are suggestions and may not work for everyone. If your symptoms persist or worsen, it’s advisable to see a healthcare professional for proper diagnosis and treatment. It’s also a good idea to do a small spot test on your skin with these remedies to ensure they do not cause further irritation.

Categorized in:

Infections,

Last Update: January 8, 2024