Lichen planus (LP) is recurrent chronic autoimmune disease of the skin and mucous membranes. It is characterized by small, shiny, red-pink lesions that are raised from the normal surface, may clump together and cause scaly plaques. It’s seen mainly in the oral cavity and skin. It can also occur in other places such as the genitals, ears, eyes and scalp. It’s common in the middle aged adults. Women are common to get oral lichen planus twice as men.
How Can One Get Lichen Planus?
It’s a T-cell mediated auto immune disease, where the T-cells destroy the normal cells of the skin and mucous membranes thinking these cells are pathological. There are several possible causes and risk factors. These factors may make the immune system think that there are pathological cells and to get rid of them by destroying them. However, it’s unclear how these factors stimulate the immune system to attack the healthy cell exactly, but when the below mentioned drugs and chemical are stopped and when the disease are treated lichen planus also cures.
The Following Is Known About Lichen Planus:
- It is not a hereditary condition, but there is rare variety of lichen planus that comes genetically, which is called familial bullous lichen planus.
- It’s not an infectious condition.
- Not a form of cancer, however long standing cutaneous ulcers and oral ulcers can give rise to a cancer.
It is not aggravated by any food items; however, spicy foods, tomato and citrus juices may aggravate the open sores in the mouth.
Precipitating Factors For Lichen Planus:
Viral infections – hepatitis B, hepatitis C
Drugs – There are some drugs that cause lichen planus. The mechanism how it actually causes the lesion is unknown. Drugs given for the treatment of malaria, hypertension, and anti-inflammatory drugs may cause lichen planus. Make sure you tell all the drugs you are taking to your doctor if you have lichen planus.
Drug induced lichen planus sometimes is indistinguishable from the non-drug induced lichen planus. Sometimes the drug induced lichen planus can look like eczema (another skin condition).
Beta blockers – These are used for treating cardiovascular disease e.g. atenolol, propranolol, metaprolol, carvedilol
ACE inhibitors – captopril, enlapril, lisinopril
Thiazide diuretics – chlorthalidone, hydrochlorothiazide
Antimalarial drugs – quinidine, chloroquine,
Sulfonylureas – tolbutamide, glipizide, glimperide, chlorpropamide
Phenothiazines – a tranquilizing drugs with antipsychotic properties
Gold – it was used to treat inflammatory conditions like rheumatoid arthritis. Now not used because of the side effects.
Arsenic – not used commonly
NSAIDS – ibuprofen, naproxen
Genetics – a rare form of lichen planus called familial bullous lichen planus runs in the families.
Stress – this is debatable
Vaccines – hepatitis B, flu vaccine
Diseases – primary biliary cirrhosis
Reactions – Lichenoid eruptions occur with graft-versus-host disease (it’s a reaction that occur in patient who have received bone marrow implants)
Chemicals- Certain chemical used in the color photograph industry
Mercury tooth fillings – can cause oral lichen planus
Lichen planus is a recurrent chronic autoimmune disease that is seen commonly in middle aged adults. It’s seen commonly in the oral cavity, other than that it’s seen in the skin, genitals, scalp, ears and eyes. It’s a T-cell mediate autoimmune disease where the immune system destroys the healthy cells in the skin and mucous membranes thinking these cells are pathological. The exact cause for this stimulation of the immune system is unknown however there several precipitating factors that is identified to trigger lichen planus. Some of these are drugs such as beta blockers, ACE inhibitors, thiazide diuretics, anti-malarial drugs and NSAID’s. Other trigger factors include viral infections like hepatitis B & C, genetics, stress, vaccines, certain chemicals used in the color photography industry and mercury tooth fillings.