Lichen Planus
Lichen planus is a chronic inflammatory skin condition and mucous membrane disorder that can affect various parts of the body. It often presents as flat-topped, itchy, and reddish or purplish bumps or rashes. Lichen planus can affect the skin, nails, mouth, genitalia, and other mucous membranes. While the exact cause of lichen planus is not well understood, it is believed to involve an abnormal immune response.
The skin lesions in lichen planus are typically shiny, flat-topped papules with a polygonal (resembling a many-sided figure) shape. These papules often have a purplish color and may develop fine white lines on their surface, called Wickham striae.Lichen planus lesions can be intensely itchy, and scratching can lead to skin damage or the development of open sores.
symptoms of lichen planus
Skin Rash: The most noticeable symptom of lichen planus is the development of small, flat-topped, shiny, reddish-purple, or purplish lesions on the skin. These lesions may be itchy and often appear in clusters.
Oral Lichen Planus: Involvement of the mucous membranes inside the mouth is common, resulting in white, lacy patches or sores (called Wickham striae). This can cause discomfort and pain when eating or drinking.
Genital Lichen Planus: In some cases, lichen planus can affect the genital area, leading to itching, burning, and the development of white or red, shiny, raised lesions.
Nail Changes: Lichen planus can affect the nails, causing ridges, grooves, thinning, or splitting.
Scalp and Hair: Lichen planus on the scalp can lead to redness, itching, and hair loss in the affected area.
Hyperpigmentation or Hypopigmentation: Lichen planus can cause changes in skin pigmentation, resulting in darker or lighter areas on the skin.
Koebner Phenomenon: Some people with lichen planus may develop new lesions in areas of skin injury or trauma, a phenomenon known as the Koebner phenomenon.
Nail Changes: Lichen planus can affect the nails, causing ridges, grooves, thinning, or splitting.
treating lichen planus
Topical Corticosteroids: These are often the first line of treatment for lichen planus. Topical corticosteroid creams or ointments can help reduce inflammation, itching, and redness. The choice of potency and formulation depends on the severity and location of the lesions.
Topical Calcineurin Inhibitors: Tacrolimus and pimecrolimus are immunosuppressive creams that may be used for lichen planus, particularly in sensitive areas or when corticosteroids are not suitable.
Oral Corticosteroids: In more severe cases or when lichen planus is widespread, oral corticosteroids may be prescribed for a short period to control inflammation and symptoms. Long-term use of oral corticosteroids is generally avoided due to potential side effects.
Oral Medications: Certain oral medications, such as antihistamines or immunomodulatory drugs like methotrexate or acitretin, may be considered in more severe or resistant cases of lichen planus.
Phototherapy: Light therapy (phototherapy) using ultraviolet (UV) light may be recommended in some cases to help manage lichen planus symptoms.
Topical Retinoids: Retinoid creams may be used to help reduce inflammation and promote cell turnover, particularly in cases where lichen planus affects the mucous membranes.