Lichen planus

About

Lichen planus is a chronic inflammatory skin condition caused by an overactive immune system. It is characterized by itchy, flat-topped, purplish lesions that may form on the skin or inside the mouth, scalp, or nails. If affects men and women of any age, but is more common in those between the ages of 30 and 60. It can last for months or years and often goes away on its own, although it can recur. Treatment typically includes topical corticosteroids, oral medications such as antihistamines, and ultraviolet light treatments.

Symptoms

The most common symptoms of Lichen planus include violet-colored, lace-like rashes on the skin and/or mouth, itchy skin lesions, and scalp lesions. Other possible symptoms include burning, blisters, and/or sores in the mouth, discoloration of the nails, and whitish patches on the tongue. Less common symptoms of Lichen planus include joint pain, vision changes, and hair loss.

Causes

The exact cause of lichen planus is not known; however, it is believed to be an autoimmune disorder. Additionally, some experts think that it may be caused by an allergic reaction to certain medications, chemicals, or metals. It has also been linked to chronic hepatitis C, contact with certain chemicals, or stress. Factors that may increase a person’s risk of developing lichen planus include an infection or certain medications, such as some antibiotics, that are known to cause allergic reactions, certain dyes or polymers used in tattoos, and long-term exposure to certain chemicals, such as formaldehyde or mercury.

Risk factors

There are a number of risk factors associated with lichen planus, including:

Exposure to certain metals or chemicals, such as hair dye, arsenic, gold, or bismuth
Certain medications or drugs, including non-steroidal anti-inflammatory drugs (NSAIDs) and antimalarial drugs
Vaccines
Cigarette smoking
Stress
Viral infections, such as hepatitis C
Genetic predisposition
Immune system dysfunction

Diagnosis

Lichen planus is usually diagnosed through a physical examination. Your doctor will look for the characteristic lesions or rash on your skin. In some cases, a biopsy may be taken from the suspicious area to detect the presence of inflammatory cells and to help confirm the diagnosis. Other tests may include a blood test to check for certain antibodies, or a skin patch test to detect any allergies.

Sub-types

Lichen planus is an inflammatory skin condition that affects about 2 percent of the population. It can cause a wide range of skin symptoms, including red, shiny patches, raised bumps, and flat-topped bumps.

There are several different subtypes of lichen planus, each with distinct characteristics:

Classic Lichen Planus: This is the most common type and features small, itchy, scaly, and raised bumps that are purple or red in color. Typically, these bumps form a symmetrical pattern on the skin.
Hypertrophic Lichen Planus: This type of lichen planus is characterized by thick, raised, and scaly plaques that are usually dark red or purple in color. Hypertrophic lichen planus is often painful and can affect areas such as the scalp, face, and back.
Atrophic Lichen Planus: Atrophic lichen planus is characterized by flat, pale, and shiny patches of skin. The patches can be itchy and may appear across the body.
Bullous Lichen Planus: Bullous lichen planus causes blisters to form on the skin, which can be very itchy. These blisters can occur anywhere on the body and can be fluid-filled or filled with pus.
Lichenoid Dermatitis: This type of lichen planus is characterized by raised red patches and plaques that are itchy and scaly. It is usually found on areas such as the neck, back, and arms.
Annular Lichen Planus: Annular lichen planus is characterized by ring-like patches of red and purple skin that may have a raised or scaly texture. These rings are usually several centimeters in diameter and can affect areas like the arms and legs.

Treatments

The treatment of Lichen planus depends on the severity of symptoms, and can range from topical medications, to light therapy, to oral medications.

Topical treatments for Lichen planus include corticosteroids, such as topical or injected corticosteroid creams or ointments. There are also topical calcineurin inhibitors that have been shown to be successful in treating Lichen planus.

Light therapy, such as phototherapy, may also be used to treat the lesions caused by Lichen planus. This can involve exposing the affected skin to ultraviolet A or B radiation.

Oral medications, such as retinoids, azathioprine, and cyclosporine can also be used to treat Lichen planus. These medications may help reduce inflammation as well as ease itching and burning.

In some cases, other medications may be used, such as immunosuppressants and antifungals. These medications may help control the underlying condition that is causing the Lichen planus.

Prevention

Reducing stress is one of the best ways to reduce the risk of Lichen planus. Regular exercise, relaxation techniques, and adequate sleep can help reduce stress levels. Other lifestyle modifications that can help reduce the risk of Lichen planus include avoiding foods with high sugar content, quitting smoking, and not consuming alcohol. In addition, avoiding certain medications that can cause Lichen planus, such as ACE inhibitors and nonsteroidal anti-inflammatory drugs, can help reduce the risk. Additionally, it is important to protect the skin from environmental triggers, such as ultraviolet rays, cold weather, and extreme temperatures.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Lichen planus. Men are more likely to have the classic type of lichen planus known as reticular LP, which usually involves red-brown, flat-topped papules on the trunk, arms, and legs. Women are more likely to have the atrophic variant of LP, which appears as a white, scarring form of lichen planus on the skin as well as the mucous membranes. Women also tend to respond better to treatment for LP than men, with higher rates of clearing after one year of treatment.

Nutrition

Nutrition plays an important role in the management of Lichen planus. Eating a healthy, balanced diet packed with essential nutrients can help manage symptoms and encourage healing of the lesions. This includes eating plenty of fresh fruits and vegetables to provide essential vitamins and minerals, lean proteins to encourage tissue repair, and healthy fats. Avoiding food allergens and incorporating anti-inflammatory foods such as omega-3 fatty acids are also beneficial. Additionally, supplementing with vitamins A, C, and E have been found to help reduce inflammation and improve skin condition. Drinking plenty of water is also important to prevent dehydration and keep the skin hydrated.

Physical Activity

Physical activity can help to reduce the symptoms associated with Lichen Planus. It can reduce stress, tension and inflammation in the body which can reduce the itching, burning and rash experienced due to Lichen Planus. Exercise can also improve mood and sense of well-being, and can help to promote healthier skin. Additionally, physical activity helps improve circulation which can help to improve the health of the affected area and improve the overall healing process.