What is Lichen Planus?
Lichen Planus is an uncommon inflammatory condition of skin, mouth, and genitals. It is thought to be due to abnormal immune reaction provoked by a viral infection or a drug. It is usually presented as a shiny itchy rash, small bumps, pink or purple in color, mouth ulcers or rash, bluish tongue or cheek.
What Age / Sex is prone to get affected with the Lichen Planus?
Lichen Planus cases are reported between the age group of 30-60 years. It occurs equally in men and women.
What is the Classification of Lichen Planus?
Lichen planus can be classified into the following types-
• Hypertrophic Lichen Planus (Lichen planus Verrucosus)- The site of onset is the extremities, especially on the shin bone.
• Atrophic Lichen Planus– Rare type characterized by plaques with central superficial atrophy.
• Bullous or Vesiculobullous Lichen Planus: This is also a rare type characterized by lichen planus lesions seen along with the vesicles and bullae (Fluid-filled lesions).
• Ulcerative Lichen Planus: It presents with chronic, painful bullae (fluid-filled lesions) and ulceration of the lesions.
• Follicular Lichen Planus: It affects hair follicles leading to scarring. Hair loss from affected parts is the main symptom.
• Lichen Planus Actinicus: It affects exposed areas of the face, dorsum of the hand, arms and nape of the neck to develop dark, lesions with rolled edges and well-defined borders.
• Lichen Planus Pigmentosus: Characterized by Dark-brown spots that develop in sun-exposed areas and folds of the skin.
• Annular Lichen Planus: Commonly involves male genitalia but also has a predilection for folds of skin such as the axilla and groin folds and made by small clusters of lesions.
• Linear Lichen Planus: Development of lesions is in a straight line, usually on extremities. May develop secondary to trauma.
What are the Causes of Lichen Planus?
The cause of lichen planus is unknown. The lesions that appear result from inflammation controlled by specific white blood cells known as T lymphocytes. However, it may also be related to other factors like-
- Allergic reactions to dental fillings.
- Hepatitis C
- NSAIDs (Non Steroidal anti-inflammatory drugs)
- Certain vaccinations.
- Genetic predisposition.
- Exposure to Dyes for eg. tattoo pigments.
- Certain medications for heart disease, high blood pressure or arthritis.
What are the Signs and Symptoms of Lichen Planus?
It is an inflammatory skin and mucous disorder that can cause multiple symptoms like-
Skin: Eruptions of lichen planus mainly on the insides of the wrists, ankles, lower back, scalp, ridges in the nails and mucous membrane of nose, mouth, genitals, and anus.
Oral: Painless white streaks located on the side of the tongue or the inner lining of the cheeks, occasionally located on the gums. Lesions occasionally form painful ulcers.
Nails: Thinning, splitting and dark lines from tip to base of the nails can be seen.
Other Symptoms include:
- Dry mouth
- Hair loss
- The metallic taste of mouth.
Prognosis
Lichen planus is usually not harmful. The condition can be treated with doctors’ advice and treatment based on the diagnosis.
What are the Complications of Lichen Planus?
There is some evidence that lichen planus may increase the risk of certain cancers
• Squamous cell carcinoma.
• Oral cancer
• penile carcinoma
• vulvovaginal cancer.
What Investigations are advised in cases of Lichen Planus?
In most cases, a doctor can diagnose the condition from physical examination of the rash. Skin biopsy to confirm the diagnosis or to rule out other conditions. In the case of oral lichen planus, a biopsy of the oral lesions is done to distinguish it from leukoplakia.
What Diet/management is advised in cases of Lichen Planus?
Self-care can help to deal with lichen planus in easier ways:
• Use cool compresses to control itching.
• Keep the skin hydrated (apply oil /moisturizers)
• Trim nails on regular intervals.
• Practice yoga or medication can help to control the stress level
• Avoid alcohol and tobacco products in the case of Oral Lesions.
• Maintain proper oral & dental hygiene.
What is the commonly indicated Homeopathic treatment for Lichen Planus?
- Arsenicum album:
- Arsenicum Iodatum
- Apis
- Borax
- Carcinosinum
- Sulphur
