Lichen Planus – Lichen planus is an autoimmune disease where the immune system mistakenly attacks the skin causing a chronic and inflammatory reaction. The skin, oral mucoso, genital mucosa, scalp and nails can all be affected by lichen planus lesions.
Autoimmune Lichen Planus
Autoimmune Lichen Planus can appear as a purplish, itchy, flat lesions that develops over several weeks. These lesions can be found in the mouth, vagina and other areas covered by a mucous membrane. Often, the lichen planus forms a lacy white patch with painful sores.
Most people can manage typical, mild cases of lichen planus at home, without medical care. If the condition causes pain or significant itching, you may need a temporary immunosuppressant to overcome an episode. Lichen planus is not contagious.
Lichen Planus Symptoms
+ Purplish, flat bumps, most often on the inner forearm, wrist or ankle, and sometimes the genitals
+ Lacy white patches in the mouth or on the lips or tongue
+ Change in scalp color
+ Painful sores in the mouth or vagina
+ Nail damage or loss
+ Blisters that break to form scabs or crusts
+ Renal: lupus nephritis.
+ Hair loss
Lichen Planus Diagnosis
+ Primary Care Physician
+ Your doctor makes a diagnosis of lichen planus based on your symptoms, your medical history, a physical examination and, if necessary, the results of lab tests. These tests may include:
- Biopsy. Your doctor removes a small piece of affected tissue for examination under a microscope. The tissue is analyzed to determine whether it has the cell patterns characteristic of lichen planus.
- Hepatitis C test. You may have your blood drawn to test for hepatitis C, which is a possible trigger for lichen planus.
- Allergy tests. Your doctor may refer you to an allergy specialist (allergist) or dermatologist to find out if you’re allergic to something that can trigger lichen planus.
Lichen Planus Treatment
Lichen planus on the skin often clears up on its own in months to years. If the disease affects your mucous membranes, it tends to be more resistant to treatment and prone to recur. Whatever treatment you use, you’ll need to visit your doctor for follow-up appointments about once a year.
Medications and other treatments might help relieve itching, ease pain and promote healing. Therapy can be challenging. Talk with your doctor to weigh the potential benefits against possible side effects of treatment.
Corticosteroids The first choice for treatment of lichen planus is usually a prescription corticosteroid cream or ointment. If that doesn’t help and your condition is severe or widespread, your doctor might suggest a corticosteroid pill or injection.
Common side effects of topical corticosteroids include skin irritation or thinning where the cream is applied and oral thrush. Corticosteroids are considered safe when taken as directed and for short-term use.
Oral anti-infections drugs Other oral medicines used in selected situations for this condition are the antimalarial hydroxychloroquine (Plaquenil) and the antibiotic metronidazole (Flagyl, others).
Immune response medicines Severe signs and symptoms may require prescription medications that suppress or modify your body’s immune response, such as azathioprine (Azasan, Imuran), mycophenolate (Cellcept), cyclosporine (Gengraf, Sandimmune, others) and methotrexate (Trexall). Antihistamines An antihistamine medication taken by mouth might relieve the itching of lichen planus. Light therapy Light therapy (phototherapy) may help clear up lichen planus affecting the skin. The most common phototherapy for lichen planus uses ultraviolet B (UVB) light, which penetrates only the upper layer of skin (epidermis). Light therapy usually requires two to three treatments a week for several weeks.
This therapy isn’t recommended for dark-skinned people, who have an increased risk of their skin staying slightly darker even after the rash clears up.
Retinoids If your condition doesn’t respond to corticosteroids or light therapy, your doctor might prescribe a retinoid medication taken by mouth, such as acitretin (Soriatane).