Lichen planus is a non-contagious medical condition where the skin develops rashes or lesions. This is thought to occur as an immune system response and the exact cause for this is not known. There can be several factors, which contribute to this condition. Some of them include allergens, viral infections, genetics and stress. There are some cases where the lichen planus occurs along with an autoimmune system disorder.
Lichen planus is not a serious or life threatening condition. However, it can be embarrassing or uncomfortable for the patient. Some types of lichen planus can be quite serious and painful; however, they are rare. The lichen planus affecting the skin is the commonest type. It takes some weeks for the rashes to develop and spread. They typically start clearing up within six months to eighteen months. Rashes can also occur on the scalp, mucous membranes, nails and genitalia; however, it is very uncommon. There are also some variations of lichen planus which are more prevalent in Asia, Middle East, Latin America and Africa.
Treatment is done to alleviate the symptoms by using topical and oral medications. Drugs which suppress the immune system (immunosuppressants) are also used.
Causes and Risk Factors of Lichen Planus
Lichen planus is thought to occur as an immune system response. The exact cause for this is not known. Risk factors include:
- Being a woman doubles your risk for developing this condition.
- Middle-aged individuals are more commonly affected by it.
- Having a family history of lichen planus increases your risk for developing it.
- Having a viral infection, such as hepatitis C, makes you more vulnerable for developing this condition.
- Exposure to certain chemicals (arsenic, gold, diuretics, antibiotics etc.), which may act as allergens may make you more susceptible towards this condition.
Signs and Symptoms of Lichen Planus
- Appearance of rashes which are purplish in color. They can appear as bumps with flat apexes also.
- These lesions, although can occur anywhere in the body, commonly develop on the wrists, inner forearms and ankles.
- The time period for development and spreading of the rashes is about two weeks to some months.
- There is also itching experienced where the rashes are.
- Lesions can also develop in the mouth and can be quite painful or can produce a burning sensation.
- Blisters are formed after some time, which rupture and crust later on.
- Appearance of narrow, white lines on the rashes is seen.
Investigations for Lichen Planus
Physical examination and medical history is usually sufficient for diagnosis. For confirmation of the diagnosis, further tests, such as allergy test, biopsy, etc. are needed. They also help in ruling out other skin conditions and viral causes, such as hepatitis C.
Treatment for Lichen Planus
There is no permanent cure for this condition. Treatment is done for relieving the symptoms. Treatment is not required for mild cases of lichen planus, as it often clears up on its own in some weeks to months. If the condition is severe and the symptoms produce discomfort, then topical as well as oral medications are prescribed for symptom relief. If the cause for the condition is found, then that cause is treated first. The following medications are used in treating lichen planus:
- Retinoids are vitamin A derivatives and can be used topically, as well as taken orally for the rashes.
- Corticosteroids help in reducing the inflammation associated with the rash. They can be used topically, orally or given via injection.
- Nonsteroidal topical creams work by suppressing the immune system and clearing up the rash.
- Antihistamines along with helping with the inflammation also help if the cause of the rash is an allergen.
- Light therapy with UV light helps in treating the rashes in some patients.