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Lichen Planus - Causes, Symptoms And Treatment of Lichen Planus

What is Lichen Planus ?

Lichen planus is rash that can be very itchy and stubborn. It usually involves the wrists, ankles, genitals and mouth but can affect any part of the body. It occurs with equal frequency in both sexes and amongst all races. Lichen planus is an uncommon skin complaint. It is thought to be due to an abnormal immune reaction provoked by a viral infection or a drug. Inflammatory cells seem to mistake the skin cells as foreign and attack them.

Lichen planus may cause a small number of skin lesions or less often affect a wide area of the skin and mucous membranes. In 85% of cases it clears from skin surfaces within 18 months but it may persist longer especially when affecting the mouth or genitals.

Causes of Lichen Planus

In many cases, the cause of lichen planus can't be found. However, you can't "catch" lichen planus from someone else or "give" it to someone else. It is not caused by stress, but sometimes stress makes it worse.

Some cases may be linked to a virus called hepatitis C. This virus can cause liver disease. Your doctor may need to order a blood test to check for hepatitis C virus. Some medicines can cause lichen planus. It is important to tell your doctor all the medicines you are taking.

Symptoms of Lichen Planus

Lichen planus appears as shiny, flat-topped bumps that often have an angular shape. These bumps have a reddish-purplish color with a shiny cast due to a very fine scale. The disease can occur anywhere on the skin, but often favors the inside of the wrists and ankles, the lower legs, back, and neck. The mouth, genital region, hair and nails are affected in some individuals. Some of the common symptoms of Lichen Planus are :-

• Ridges in the nails like onycholysis
• Lichen planus can appear on any area of the skin. The most common areas are the inner wrists, the forearms and the ankles.
• Dry mouth.
• Itching in the location of a lesion, mild to severe.
• On the scalp, lichen planus may cause hair loss.
• In the mouth, it looks like lacy white patches on the inside of the cheeks or on the tongue.
• Metallic taste in the mouth.

Treatment of Lichen Planus

There is no known cure for skin lichen planus, but treatment is often effective in relieving itching and improving the appearance of the rash until it goes away. Since every case of lichen planus is different, no one treatment does the job. Some of the common treatment of Lichen Planus are :-

• There is no specific treatment for lichen planus. Cortisone creams and ointments are sometimes helpful.
• Antihistamines help the itching.
• Occlusive dressings may be placed over topical medications to protect the skin from scratching.
• Ultraviolet light therapy may be beneficial in some cases of Lichen Planus.
• In extensive cases systemic steroids such as prednisone may be prescribed for a few weeks or longer. This will lessen the itch and often clear up the lichen planus completely.
• Tacrolimus ointment and pimecrolimus cream , immune modulating drugs that inhibit calcineurin, may be useful for oral and genital lichen planus.
• If the bumps don't go away, or if you have many bumps, you may need stronger medicines. Your doctor may give you a medicine called prednisone (say: "pred-ni-zone"). It comes in shots or pills. Prednisone has many side effects, so take this medicine with the advice of the doctor.

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