Skin problems are very common. Most of the times, we tend to ignore it; and most of the skin problems go on its own. But some skin problems are troublesome, and persist for long. One such skin disorder is Lichen Planus.
About Lichen Planus
Appearance of purple red bumps on the skin that is itchy and inflamed is due to a condition called as Lichen Planus (LP). The bumps are usually flat and irregular in shape, close observation may show white scales or flakes on the bumps. Lichen planus is seen commonly in the inner wrist, forearm, and the ankle. Sometimes, lichen planus can affect nails, scalp, inside of mouth, genitals, and anus. The symptoms varies according to the area it appears, for instance, on nails it results in brittle and split nails; on scalp it causes hair loss; inside the mouth it looks like white patches on the inside of cheeks and on the tongue. LP in mouth and genital regions causes soreness and burning sensation. A single episode of LP can last for over several months or even years. LP affects men and women equally but oral LP is seen twice as often in women as in men. It mostly affects middle aged person.
Causes
What causes LP is still not clear. But there are many predicted reasons for LP. Lichen planus is thought to be an autoimmune disease, where the body’s immune system acts against normal organs like hair, skin, mouth etc. It may also be due to allergic reactions to medications taken for high blood pressure, heart disease, and arthritis can cause LP rashes. Having hepatitis C can also cause LP. LP is not contagious, it is not caused by stress, it is not an infectious disease, it is not a form of cancer, it is not inherited, and it is not related to any nutritional deficiency.
Symptoms
Presence of LP can be identified by mild or severe itching. Large flat-topped lesions may be present on the skin. The lesions may have shiny and scaly appearance, and there could be small purplish red bumps. Bumps are present for several weeks and months; they might go and come back again. Dark brown patches may appear after the bumps disappear. LP in mouth may cause painful sore in the mouth that make eating difficult, and cause mouth dryness and metallic taste in mouth. White patches may appear in the cheeks and tongue. In mouth, there is a gradual increase in the size of affected region. Mouth lesions can form painful ulcers. In nails, it causes brittle and split nails. In scalp, LP results in hair loss. There could be soreness and burning sensation, if LP affects genitals and anus.
Diagnosis
The diagnosis is better made by a dermatologist or an oral or dental surgeon. For diagnosing LP examination of the symptoms on the skin and mouth is enough. Sometimes, biopsy of the skin or mouth lesion is done to confirm LP. Blood test will also be done to check whether the patient is suffering from hepatitis.
Treatment
Treatment for LP provides relief from symptoms but does not cure the disease. In severe cases, immunosuppressive drug like cyclosporine is prescribed.
Treatment for skin LP: Treatment for skin LP is aimed at reducing itching and rashes. The very common treatment is prescribing creams, ointments containing corticosteroid or anti-inflammatory drugs, and oral anti-histamine. Topical retinoic creams helps in reducing inflammation, itching and aids in fast healing. Sometime dressing over the rash may prevent the patient from itching. In severe case of LP stronger medicines like oral cortisone or ultraviolet treatment called PUVA (Photo chemotherapy light treatment) is recommended. As new injury can cause LP so try to avoid injuries.
Treatment for mouth LP: LP of the mouth does not have any cure though treatment can eliminate pain and sores. If LP do not cause any pain or burning sensation then treatment is usually not required. If it exhibits symptoms like pain, burning, redness, blisters, sores, and ulcers then doctor may prescribe topical creams and oral medications. Lidocaine mouth washes helps to numb the sores and make eating comfortable.
Outlook
LP is an unpleasant condition that is difficult to treat, but fortunately it is a stable condition as the severity or the symptoms of the disease rarely changes after first few months of appearance. Although LP cannot be cured completely, doctor will be able to prescribe medications that will help reduce the symptoms. Learning about the disease is very essential in managing the disease and controlling the symptoms.
