Lichen Planus
What is it?
Lichen planus
is a skin condition that causes itchy, flat-topped bumps
that develop into scaly patches.
Who gets it?
Lichen planus
can occur in anyone, but is more common during middle age.
What causes
it?
The exact cause
of lichen planus is unknown. It may be related to a viral
infection or a reaction to a chemical, such as those used
to develop color photographs. In some people, certain
drugs such as streptomycin, tetracycline, gold, arsenic,
bismuth, quinacrine, quinidine, and quinine cause a
reaction that looks like lichen planus. People who have
lichen planus in the mouth may be allergic to certain
medications, ingredients in candy or gum, or products used
during dental procedures. Lichen planus is not contagious.
What are the
symptoms?
Lichen planus
on the skin looks like small, raised spots with flat tops,
ranging in color from pink to purple. With time, they
develop white lines or spots and a purplish sheen that can
be seen from a certain angle under light. The white lines
are called Wickham's striae. These patches usually occur
on the inner parts of the wrists, on the lower legs, on
the tip of the penis or in the vagina, and on the torso.
They have also been seen in the gastrointestinal tract,
the bladder, the conjunctiva of the eye, and the larynx.
The bumps can be extremely itchy. Areas of skin affected
by lichen planus may be discolored after the condition
heals. It is less common for lichen planus to appear on
the scalp and nails. When it does, it leaves behind
permanent changes, such as bald patches or damage to the
nail. Lichen planus can also occur in the mouth, with
symptoms ranging from painless white patches to sore gums
and painful ulcers that make eating and drinking
difficult. When lichen planus appears on mucous membranes,
such as the mouth, it usually has a white, lacy
appearance. Although rare, ulcerative lichen planus in the
mouth can increase the risk of mouth cancer. Ulcerative
lichen planus can also occur on the palms of the hands and
soles of the feet. People with lichen planus are more
likely to have the hepatitis C infection.
How is it
diagnosed?
To diagnose
lichen planus, your doctor will examine your skin. In most
cases, the characteristic appearance of the patches is
enough to make a diagnosis. Your doctor may want to take a
small sample of the affected skin, called a skin biopsy,
to make a definite diagnosis.
What is the
treatment?
Lichen planus
usually heals on its own within two years. Your doctor can
prescribe medication such as antihistamines to relieve
itching. Corticosteroids, which can be injected into the
affected areas, taken by mouth, or applied to the skin,
also help control inflammation and itching. People with
severe lichen planus may benefit from psoralens plus
ultraviolet A (PUVA) treatment, which combines drugs to
make the skin more sensitive to ultraviolet light (psoralens)
with phototherapy. Medicated mouthwashes can help relieve
pain from ulcers in the mouth. Patients with painful
ulcers on the palms or soles of the feet may find relief
by applying creams containing tretinoin, then covering the
affected area with a light dressing. If lichen planus
symptoms occur as a reaction to certain drugs or
allergies, discontinuing that drug or avoiding the
products that trigger the allergic reaction can prevent
lichen planus.
Self-care tips
If you know
that you are sensitive to the drugs or products that can
cause lichen planus symptoms, make sure your doctor and
dentist are aware of this. Although most people are rid of
this skin condition after it heals, a small percentage of
people will have recurring bouts of lichen planus. Follow
your doctor’s recommendations for follow-up treatment if
the condition comes back.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
