Description

Lichen planus (LIE-kun PLAY-nus) is a condition of the skin, hair, nails, mouth, and genitals. On the skin, lichen planus, which often appears as purple, itchy, flat bumps that develop over several weeks. In the mouth and genital mucosal, lichen planus forms lacy white patches, sometimes with painful sores.

Mild lichen planus of the skin may not need treatment. If the condition causes pain or severe itching, you may need prescription medicines.

Symptoms

The symptoms of lichen planus, which vary depending on the affected part of the body. The nails of the disease usually affect several nails. The symptoms include:

  • Purple, bright, flat bumps, often on the inside of the forearms, wrists, or ankles.
  • Lines of skin rash has been removed.
  • Lacy white patches on the tongue or inside the cheeks.
  • The itching.
  • Painful sores in the mouth or on the genitals.
  • Rarely, the loss of hair.
  • Nails scarring or loss.
  • The dark lines of the tip of the nail to the base.

When to see a doctor

Consult your health care provider if the small bumps or a rash appears on the skin for no known reason, such as contact with poison ivy. Also consult with your health care provider if you have any of the symptoms associated with lichen planus of the mouth, genitals, scalp, or nails.

It is best to get an early and correct diagnosis due to a number of skin and mucous membrane conditions can cause sores and the pain.

Causes

The cause of lichen planus is probably related to the immune system attacking the cells of the skin or mucous membranes. It is not clear why this spot of the immune response that occurs. The condition is not contagious.

Lichen planus can be activated by:

  • Hepatitis C infection.
  • Pain relievers and other medications.
  • An allergic reaction to the metal in dental fillings.

Risk factors

Any person can develop lichen planus. It most often affects middle-aged adults. Lichen planus in the mouth is more likely to affect women than men.

Complications

Lichen planus can be difficult to treat in the vulva and in the vagina. You can cause scarring and severe pain. Sores on the genitals can cause painful sexual intercourse.

The affected skin and nails may remain slightly more dark, even after healing.

Oral ulcers may affect your ability to eat. Oral lichen planus increases the risk of oral cancer. Rarely, lichen planus affects the ear canal. Is left without treatment, it can lead to hearing loss.

Diagnosis

To find the cause of your disease, your doctor will probably talk to you about your symptoms and medical history and perform a physical examination. You may also need some tests. These may include:

  • The biopsy. The doctor removes a small piece of affected tissue for examination in a laboratory. The tissue is then examined to see if the patterns of cells typical of lichen planus.
  • Blood tests. You can have a sample of your blood to test for health problems related to lichen planus. For example, hepatitis C.

Treatment

If you don't have pain or discomfort, you may not need any treatment. Lichen planus on the skin often goes away by itself in months to years.

Medicines and other treatments can help relieve the itching, relieve pain and accelerate healing. Talk with your health care provider to weigh the pros and cons of the treatment options. You may need more than one strategy for the control of their symptoms.

If the disease affects the mucous membranes, and nails, which tends to be more difficult to treat. Even if the treatment works, the symptoms may return. It is likely that you will need to visit your health care provider for follow-up care at least once a year.

Corticosteroids

Often the first choice for the treatment of lichen planus of the skin is a prescription corticosteroid cream or ointment. This may help to relieve the pain, swelling and inflammation.

If a topical corticosteroid that doesn't help, and your condition is severe or widespread, your health care provider may suggest corticosteroid pills or injections.

The side effects vary, depending on the method of use. Corticosteroids are safe when used as directed.

Oral anti-infection drugs

Other oral medications used for lichen planus are the antimalarial drug hydroxychloroquine (Plaquenil), and the antibiotic metronidazole (Flagyl, other).

The immune response of the medicines

For more severe symptoms, you may need to take prescription medications that changes the body's immune response. The following medications have been used with some success, but further studies are needed:

  • cyclosporine (Sandimmune).
  • Azathioprine (Azasan).
  • methotrexate (Trexall).
  • mycophenolate (Cellcept).
  • sulfasalazine.
  • thalidomide (Thalomid).

Antihistamines

An antihistamine medication that is taken orally and may relieve the itching of the skin caused by lichen planus.

Light therapy

The light therapy can help to clarify the lichen planus affecting the skin. This approach is also called phototherapy. A method involves exposing the skin to ultraviolet B light 2 to 3 times a week for several weeks.

A possible side effect is that the long lasting changes in the color of the skin (hyperpigmentation), even after the skin heals.

Retinoids

Your health care provider may prescribe a retinoid medicine that is taken by mouth or applied to the skin. An example is the acitretin.

Retinoids can cause birth defects, so this type of medicine is not for people who are pregnant or may become pregnant. If you are pregnant or breast-feeding, your health care provider may suggest that you delay the treatment, or to choose a different treatment.

Dealing with triggers

If your doctor thinks that your lichen planus is related to an infection, allergies, a medicine you are taking or some other trigger, you might need another treatment or tests at the address. For example, you may need to change the medicine or your doctor may recommend additional tests to the allergens.

Lifestyle and home remedies

Self-care measures can help reduce the itching and pain caused by lichen planus. These include:

  • Take a bath in lukewarm water. Sprinkle the oatmeal in a based bath product (Aveeno, other). Rinse well, pat dry and apply a moisturizer.
  • The application of a cool, damp cloth.
  • Using the type of hydrocortisone cream or ointment that you can get at a store without a prescription. Obtain a product that has at least 1% hydrocortisone. Do this only if you are not using a prescription corticosteroid product on your skin.
  • Avoid scratching of the skin and wounds to your nails.
  • Brushing your teeth twice a day and flossing daily, if you have oral lichen planus.

Alternative medicine

A few small clinical trials have suggested that the benefits of aloe vera gel for the treatment of lichen planus of the vulva and aloe vera mouthwash for mouth disease.

Search in the alternative medicine approaches that can help to reduce stress, as stress can worsen the symptoms of lichen planus.

Talk with your health care provider before trying an alternative treatment for lichen planus. Some alternative medicines or supplements often have unwanted side effects.

Preparing for your appointment

It is likely to start by seeing your primary care provider. Or you may be referred to a doctor who specializes in skin diseases (dermatologist). If the disease affects the vulva or vagina, you may be referred to a specialist in disorders of the female reproductive system (gynecologist).

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

  • The symptoms that you've had and for how long.
  • All the drugs, vitamins, and supplements you are taking, including the dosage.
  • Questions to ask your health care provider.

For lichen planus, some basic questions to ask your health care provider include:

  • What is the most likely cause of my symptoms?
  • There are other possible causes?
  • Do I need any tests?
  • How much time do these changes in the skin for the last time?
  • What treatments are available, and which do you recommend?
  • What side effects can I expect from treatment?
  • I have these other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • You should see a specialist?
  • Is there a generic alternative to the medicine you're prescribing?
  • Do you have any brochures or other printed material that I can take with me? What sites do you recommend?

What to expect from your doctor

Your health care provider is likely to ask a series of questions, such as:

  • In which place of your body that you have noticed the symptoms?
  • Are the affected areas that are itchy or painful?
  • I would describe the pain as mild, moderate, or severe?
  • He has recently started a new medication?
  • Have you recently received a vaccine?
  • Do you have any allergies?
Symptoms and treatment of Lichen planus