Lichen planus is an inflammatory skin ailment that causes swelling and irritation of the skin, hair, nails, and mucous membranes. Lichen planus commonly shows on the skin as reddish, itchy, flat lumps that form over many weeks. Lichen planus causes lacy white patches in the mouth, vagina, and other mucous membrane-covered places, sometimes accompanying painful blisters.
Most people may treat typical, moderate occurrences of lichen planus at home without seeking medical attention. If the illness produces severe itching or discomfort, you may require prescription medication. Lichen planus does not spread.
WHAT ARE THE SYMPTOMS OF LICHEN PLANUS?
Lichen planus symptoms and manifestations differ based on the region afflicted. The following are typical indications and symptoms:
- Purplish, flat pimples, usually on the inner forearm, wrist, or ankle, but often on the genitals.
- Itching
- Blisters that rupture and develop scabs or crusts
- Color shift in the scalp
- Damage or loss of nails
- Lacy white areas around the mouth, lips, or tongue
- Sores in the mouth or vaginal area that are painful
- Loss of hair
WHAT ARE THE CAUSES OF LICHEN PLANUS?
Lichen planus develops when your immune system targets skin or mucous membrane cells. It is unclear why this aberrant immune response occurs. The disease is not communicable.
Lichen planus can be brought on by:
- Hepatitis C infection
- Flu vaccine
- Pigments, chemicals, and metals
- Pain relievers, like ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others)
- Certain heart disease, high blood pressure, and arthritis drugs
WHAT ARE THE RISK FACTORS FOR LICHEN PLANUS?
Lichen planus may affect anyone. However, the illness primarily affects middle-aged people. Oral lichen planus is more common in middle-aged women.
WHAT ARE THE COMPLICATIONS OF LICHEN PLANUS?
Lichen planus on the vulva and in the vagina can be difficult to treat, causing significant discomfort and occasionally leaving scars. Sexual dysfunction might develop into a long-term problem. Oral sores can make it difficult to eat. Even after the rash has cleared up, the afflicted skin may remain somewhat darker, especially in persons with dark complexion.
Oral lichen planus raises the chance of developing oral cancer. Lichen planus of the ear canal, if left untreated, can cause hearing loss.
HOW IS LICHEN PLANUS DIAGNOSED?
Lichen planus is diagnosed by your doctor based on your symptoms, medical history, physical examination, and, if required, the results of lab testing. Among these tests are:
- Biopsy: A tiny piece of damaged tissue is removed by your doctor for evaluation under a microscope. The tissue is examined to see if it contains the typical cell patterns of lichen planus.
- Hepatitis C test: Your blood may be collected to test for hepatitis C, which is a probable cause of lichen planus.
- Allergy tests: If you are allergic to anything that might cause lichen planus, your doctor may recommend you to an allergy expert (allergist) or dermatologist.
Other tests may be required if your doctor believes you have lichen planus, such as the form that affects the esophagus, genitals, ears, or mouth.
WHAT ARE THE TREATMENTS FOR LICHEN PLANUS?
Lichen planus on the skin usually goes away on its own after a few months or years. If your condition affects your mucous membranes, it is more resistant to therapy and more likely to reoccur. Whatever therapy you choose, you'll need to see your doctor roughly once a year for follow-up sessions.
Medications and other therapies may be used to alleviate itching, relieve pain, and improve healing. Therapy can be difficult. Consult your doctor to assess the potential advantages against any treatment adverse effects.
- Corticosteroids: A prescription corticosteroid cream or ointment is typically the first line of therapy for lichen planus. If it doesn't work and your disease is severe or widespread, your doctor may advise you to take a corticosteroid tablet or get an injection.
Skin irritation or thinning where the cream is administered, as well as oral thrush, are common adverse effects of topical corticosteroids. When used as indicated and for a short period of time, corticosteroids are considered safe.
- Oral anti-infections drugs: Other oral medications used to treat this illness include the antimalarial hydroxychloroquine (Plaquenil) and the antibiotic metronidazole (Flagyl, others).
- Immune response drugs: Severe signs and symptoms may need the use of prescription drugs that inhibit or change your immune system, such as azathioprine (Azasan, Imuran), mycophenolate (Cellcept), cyclosporine (Gengraf, Sandimmune, and others), and methotrexate (Trexall).
- Antihistamines: Lichen planus irritation may be relieved by taking an antihistamine by mouth.
- Light therapy: Light treatment (phototherapy) may help clean up skin lichen planus. The most often used phototherapy for lichen planus is UVB radiation, which only penetrates the top layer of skin (epidermis). Light therapy normally necessitates two to three sessions each week for a few weeks.
This therapy is not indicated for those with dark skin, who are at a higher risk of their skin remaining slightly darker even after the rash has cleared up.
- Retinoids: If corticosteroids or light treatment are ineffective, your doctor may prescribe an oral retinoid medicine like as acitretin (Soriatane).
Because retinoids might cause birth abnormalities, they are not recommended for pregnant or planning to become pregnant women. If you are pregnant or breastfeeding, your doctor may decide to postpone or change your topical retinoid therapy.
Managing Triggers
If your doctor believes that your lichen planus is caused by a hepatitis C infection, allergies, or a medicine you are taking, you may require further therapy. For example, you may need to change prescriptions or avoid allergies. For additional treatment, your doctor may recommend you to an allergist or, in the event of a hepatitis C infection, a specialist in liver illness (hepatologist).