Lichen Planus

Lichen Planus is a comparatively common skin disease which comes in episodes lasting months to years. Lichen planus is an uncommon disorder involving a isochronous, itchy, inflammatory rash or lesion on the skin or in the mouth. The actual cause is unknown, but the disorder is probably to be related to an allergic or immune reaction. It appears to be a reaction in respond to more than one provoking factor. Theories involve stress, genetics, infective and immunologic.

There are also drugs which produce lichen planus-like allergic reactions to high blood pressure, heart disease, and arthritis medications. Lichen planus often affects middle age adults. It is less frequent in children. The foremost attack may last for weeks to months, and come and go for years.

Lichen planus may also affect the scalp, the nails or the inside of the mouth. On the scalp, lichen planus may cause hair loss. Lichen planus of the nails can cause delicate or split nails. In the mouth, it appears like lacy white patches on the inside of the cheeks or on the tongue.

Lichen planus can also cause ulcers in the mouth but this is uncommon. If they occur they can be very sore and displeasing. Lichen planus of the mouth most often affects the inside of the cheeks, gums and tongue. Oral lichen planus basically appears as patches of fine white lines and dots. These variations usually do not cause symptoms. Dentists while regular check-ups often find them. Hot or spicy foods are specially complicated to eat. Mouth ulcers can occur with or without the skin rash. In some cases, the gums become red and sore.

More severe forms of oral lichen planus can cause painful sores and ulcers in the mouth. Lichen planus inside the mouth may cause painful sores which make it hard to eat. There are many various treatments available for treating the condition. Your dentist will be able to suggest an appropriate one for you. Mouthwashes containing Chlorhexidine are used when no pain is manifest. There are also special sprays and creams available to help relieve pain.

Causes of Lichen planus

The cause of lichen planus is unknown. In few rare cases, lichen planus is a reaction to a specific medicine or contact with chemicals used in colour photographic developing. Lichen planus may be related with several other disorders, most notably hepatitis C. Chemicals or medications linked with development of lichen planus include gold, antibiotics, arsenic, iodides, chloroquine, quinacrine, quinidine, antimony, phenothiazines, diuretics such as chlorothiazide, and many others.

Common causes and risk factors of Lichen planus:

Emotional stress.
Contact with chemicals used in colour photographic developing.
Reaction to a particular medicine (such as beta-blockers, anti-inflammatory medicine or gold injections for arthritis).
Spicy food or citrus fruits can often cause symptoms to worsen.

Signs and Symptoms of Lichen planus

Lichen planus on the skin is generally itchy. Many skin and mucous membrane conditions appear alike. Only your physician, or perhaps only a dermatologist, can tell them apart. If you have anything aliking lichen planus, do not assume which is what it is. Skin conditions may be isolated, or they may be signs of more serious internal disease. The spots of lichen planus can be found in the skin creases of the wrists, elbows and ankles, and in the lower back and genital areas. Lichen planus can affect the scalp where it destroys the hair follicles causing patches of hair loss. Nails may be affected and become thin and damaged, forming a lengthways groove along the nail.

Sign and symptoms may include the following :

Itching in the location of a lesion, mild to severe.
Bumps may appear in areas of trauma on some individuals.
Ridges in the nails.
Dry mouth.
Shiny, flat-topped bumps that often have an angular shape.
Blisters may rarely occur.

Treatment for Lichen planus

There is no cure for lichen planus, but medicine can help the itching and rash get better. As long as there is no pain, treatment is not usually necessary. In all cases it is important to keep your mouth clean, as it stops the lichen planus getting infected. If lichen planus is only on a small part of your body, you can use a hydrocortisone cream that you apply directly to the bumps. You may use light therapy for lichen planus. Or, you could take a pill with a retinoid in it. Retinoids have many side effects. You have to have regular blood tests while you take this medicine.

Treatment may include:

Topical corticosteroids are very useful.
Antihistamines may be prescribed to relieve itching.
For severe cases powerful treatments include photo chemotherapy light treatment (PUVA), the retinoids drugs (Soriatane and Accutane), Neoral and Plaquenil.
The use of lotions containing anti-itch ingredients such as menthol, pramoxine and phenol may be helpful.
Occlusive dressings may be placed over topical medications to protect the skin from scratching.
Ultraviolet light therapy may be beneficial in some cases.

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