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Lichen planus

Lichen planus



Overview

Lichen planus (LIE-kun PLAY-nus) is a condition of the skin, hair, nails, mouth and genitals. On skin, lichen planus often appears as purple, itchy, flat bumps that develop over several weeks. In the mouth and genital mucosa, lichen planus forms lacy white patches, sometimes with painful sores.

Mild lichen planus of the skin may not need treatment. If the condition causes pain or intense itching, you may need prescription medicine.

Lichen planus isn’t an autoimmune condition, but it can cause a similar response. It’s an idiopathic (meaning the cause is unknown) condition that causes inflammation in your skin. In lichen planus, your body’s immune system attacks parts of your body instead of protecting your body from foreign invaders like bacteria or viruses.

In a healthy immune system, special cells in it called T cells help protect your body from infection. In people with lichen planus, their immune system’s T cells attack a protein in their skin and mucus membranes.

No one knows why the T cells attack the protein.

Anyone can get lichen planus. However, you’re more likely to develop it if you’re between 30 and 60 years old and a woman.

Some studies suggest women might get lichen planus twice as often as men, and they’re more likely to develop it in their 60s. Men are more likely to develop it in their 40s.

If you have lichen planus on your skin, you’re 50% to 75% more likely to have it in your mouth.

Lichen planus commonly affects the skin around your wrists and elbows (flexor surfaces), the back of your hands (dorsal surfaces) and the fronts of your lower legs.

About half of all people who have lichen planus develop oral lichen planus, which affects the skin inside of your mouth and your tongue.

The affected spots (lesions) on your body usually start as tiny, raised dots (papules) that are about the size of the tip of a pin (0.4 millimeters [mm]). They may grow up to the width of a pencil (1 centimeter [cm]).

Oral lichen planus typically starts as tiny white dots on the skin inside of your cheeks or your tongue. In severe cases, the surrounding skin may become inflamed, and sores may develop.

Symptoms

Lichen planus symptoms depend on where it’s affecting your body:

Tiny, raised dots may develop on your skin, including your genitals. The dots are about the size of the tip of a pin (0.4 mm), and they may grow to the width of a pencil (1 cm). They may also develop into sores.

Tiny white dots may develop on the skin inside of your cheeks, your tongue or your lips.

Your nails may change colors, crack or split, stop growing or fall off.

Lichen planus doesn’t hurt. However, if you scratch your rash, you may break your skin, leading to an infection that can cause pain.

Causes

The following may cause lichen planus flare-ups:

Hepatitis C.

Vaccines.

Nonsteroidal anti-inflammatory drugs (NSAIDs).

Particular medications used to treat arthritis, heart disease or high blood pressure.

Particular chemicals, metals or pigments.

Diagnosis

Your healthcare provider can typically diagnose lichen planus after assessing your symptoms and conducting a physical exam. They may look for characteristics known as the “six Ps” that help diagnose lichen planus:

Pruritic (They’re itchy).

Polygonal (Your rash shape has many sharp angles).

Planar (The top is flat).

Purple papules (bumps).

Plaques (raised, discolored, patches).

If there’s any doubt, your healthcare provider may perform the following tests:

Allergy test. An allergy test can determine if you have an allergy that’s causing your lichen planus flare-up.

Biopsy. Your healthcare provider will use a thin blade (scalpel) or a punch tool to collect a small sample of skin from your rash. Your skin sample goes to a laboratory for testing and pathologists examines it under a microscope.

Hepatitis C test. Lichen planus is sometimes associated with the hepatitis C virus.

Treatment

There isn’t a cure for lichen planus. If you have lichen planus on your skin, in most cases, it goes away without treatment in as little as a few months to several years.

The following treatments may help relieve your symptoms:

Corticosteroid creams or ointments. Your healthcare provider may prescribe corticosteroid creams or ointments to reduce inflammation.

Antihistamines. Antihistamines are a class of drugs commonly used to treat allergy symptoms, including itchy skin.

Phototherapy. Phototherapy uses ultraviolet light, usually ultraviolet B (UVB), from special lamps. The ultraviolet light waves found in sunlight can help certain skin disorders, including lichen planus.

Immunosuppressants. Medications that lower your immune system such as oral corticosteroids, mycophenolate mofetil, azathioprine or cyclosporine can be helpful.

Retinoids (vitamin A derivatives). Retinoids are a pill or ointment that help your body produce more collagen and blood vessels, which can help your rash. Retinoids may cause birth defects, so it’s a good idea to check with your healthcare provider if you’re pregnant or planning to become pregnant.

If you have lichen planus in your mouth, in most cases, it goes away within five years. If you experience irritation or sores, you can help alleviate your symptoms by:

Practicing good oral hygiene. Regularly brush and floss your teeth, and get your teeth professionally cleaned by your dentist at least twice a year.

Minimize injuries (trauma). Injuries to your mouth can increase the severity of your sores, as well as how often flare-ups occur. Gently brush your teeth, put dental wax around braces or orthodontic wires and consider removing any piercings that bump or rub against the inside of your mouth.

Replacing dental fillings. Though rare, some people have allergies to the mixtures of different metals (amalgams) used in tooth fillings. These allergic reactions may look similar to lichen planus. Replacing amalgam fillings with a hypoallergenic material that won’t cause an allergic response may improve your irritation or sores.

There are any home remedies for symptoms of lichen planus:

There are several over-the-counter products or home remedies that can help stop your rash from itching.

While home remedies are safe for most people, it’s a good idea to check with your healthcare provider before trying some of the following options. You may be at risk of developing an allergic reaction.

Aloe vera. Aloe vera is a wound care gel that can moisturize, heal and treat sores. Some research suggests that it can relieve lichen planus symptoms in your mouth or on your vulva.

Antihistamines. Antihistamines are a class of drugs commonly used to treat allergy symptoms, including itchy skin.

Hydrocortisone creams or ointments. Over-the-counter (OTC) hydrocortisone is a corticosteroid combined with an anesthetic pain reliever.

Oatmeal: The best way to use oatmeal on your lichen planus skin rash is to grind it into a fine powder (colloidal oatmeal) in a blender or food processor. Mix the oatmeal powder with warm water until it becomes a thick, sticky paste. Apply enough of the oatmeal paste to cover your rash completely. After at least 10 minutes, wipe off the paste with a clean towel.

Stress can also make skin disease worse. There are mental/emotional signs of stress and physical signs of stress. Stress management techniques can help you prevent or ease your stress-induced lichen planus symptoms.

Type of Doctor Department :A dermatologist

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