Summary about Disease
Lichen planus is an inflammatory condition that can affect the skin, mouth, nails, and genitals. It's characterized by small, flat-topped, itchy bumps (papules) on the skin. In the mouth, it appears as white, lacy patches, red swollen tissues, or open sores. It is not contagious.
Symptoms
Skin: Purplish, flat-topped bumps, most often on the wrists, ankles, and lower back. Itching is common, ranging from mild to severe. Blisters may also occur.
Mouth: White, lacy patches (most common), red swollen tissues, or open sores. Burning pain or discomfort when eating or swallowing. Altered taste sensation.
Nails: Ridging, thinning, splitting, or loss of the nail.
Genitals: Painful sores in women. Redness or bumps in men.
Causes
The exact cause of lichen planus is unknown. It's thought to be an autoimmune disorder, where the body's immune system attacks its own tissues. Possible triggers include:
Certain medications (e.g., NSAIDs, some heart medications)
Hepatitis C infection
Allergens
Stress
Genetic factors may play a role.
Medicine Used
Treatment aims to reduce symptoms and promote healing. Common medications include:
Corticosteroids: Topical creams or ointments for skin lesions; oral corticosteroids for severe cases.
Antihistamines: To relieve itching.
Retinoids: Topical or oral medications to promote skin cell turnover.
Light therapy (phototherapy): Exposure to ultraviolet light.
Calcineurin inhibitors: Topical medications to suppress the immune response.
Other: Tacrolimus, pimecrolimus, Dapsone, Griseofulvin.
Mouth: Topical corticosteroids, topical or systemic retinoids, calcineurin inhibitors, mouthwashes containing lidocaine or other numbing agents.
Is Communicable
No, lichen planus is not contagious. It cannot be spread from person to person through physical contact or any other means.
Precautions
Avoid known triggers, such as certain medications or allergens, if identified.
Practice good oral hygiene, especially if you have oral lichen planus.
Manage stress.
Protect affected skin from injury.
Follow your doctor's treatment plan carefully.
Avoid irritating foods, such as acidic, spicy, or crunchy foods if you have oral lichen planus.
How long does an outbreak last?
Lichen planus duration varies. Skin lesions typically clear within months to years, with an average duration of 1-2 years. Oral lichen planus can be more chronic, lasting for many years, with periods of remission and flare-ups. Nail involvement can be particularly persistent.
How is it diagnosed?
Diagnosis usually involves:
Physical examination: A doctor will examine the skin, mouth, and nails.
Medical history: The doctor will ask about your symptoms, medications, and medical conditions.
Skin biopsy: A small sample of affected tissue is removed and examined under a microscope. This is the most definitive way to diagnose lichen planus.
Allergy testing: To rule out allergic reactions as a cause.
Hepatitis C testing: To rule out Hepatitis C as a possible trigger.
Timeline of Symptoms
The timeline can vary considerably:
Initial outbreak: Gradual appearance of purplish bumps (skin), lacy white patches (mouth), or nail changes.
Progression: Lesions may spread or coalesce. Itching may worsen.
Plateau: Symptoms may stabilize for a period.
Remission: Symptoms may improve or disappear completely.
Recurrence: Symptoms may reappear after a period of remission.
Important Considerations
Lichen planus can sometimes leave behind dark spots (hyperpigmentation) after the lesions heal.
Oral lichen planus may slightly increase the risk of oral cancer, so regular dental checkups are important.
Nail involvement can be difficult to treat and may result in permanent nail damage.
Although not life-threatening, lichen planus can significantly impact quality of life due to itching, pain, and cosmetic concerns.
It is important to seek medical attention for proper diagnosis and management.