Q. What is lichen planus
A. 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.
Q. Who are more prone to develop lichen planus?
A. Lichen Planus cases are reported between the age group of 30-60 years. It occurs equally in men and women.
Q. Can it spread through touch? Is it contagious?
A. Lichen planus is not caused by germs, bacteria, viruses. So it doesn’t spread by touch, sharing utensils or physical touch.
Q. How much time does it take to treat lichen planus?
A. The length of treatment depends upon following factors:
- Duration of lichen planus
- Extent of disease
- Probable cause
- Location of disease
- Previous disease
Q. What clinical history is characteristic of lichen planus?
A. In most cases, the development of lichen planus is insidious. However the lesions usually develop on flexural surface of the limbs such as wrist followed by a generalized eruption that develops with maximal spreading within 2 to 16 weeks.
Q. Can lichen planus be classified into further types?
A. Yes, Lichen planus can be further classified as:
- Hypertrophic Lichen Planus (Lichen planus Verrucosus) – site of onset is 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 develop dark, lesions with rolled edges and well-defined borders.
- Lichen Planus Pigmentosus– Characterized by Dark-brown spots 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.
Q. What is the triggering factor of lichen planus?
A. Cause of lichen planus is unknown. The lesions that appear are a result of inflammation controlled by specific white blood cells known as T lymphocytes. However, it may also be related to an allergic or immune reaction. Hepatitis B, C infection.
- Allergens (Allergy causing agents)
- Exposure to Dyes for eg.tattoo pigments.
- Non-steroidal / anti-inflammatory drugs.
- Certain medications for heart disease, high blood pressure or arthritis.
Q. How does lichen planus present itself?
A. Lichen planus can manifest as skin and oral symptoms. These are given as below
Skin: Eruptions of lichen planus mainly on 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 on the inner lining of the cheeks, occasionally located on the gums. Lesions occasionally form painful ulcers.
Other Symptoms:
- Dry mouth
- Hair loss
• The metallic taste of mouth
Q. How can I get my condition diagnosed?
A. 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.
Q. How can I manage this condition through lifestyle management?
A. Yes, condition can be managed through lifestyle modification to a certain extent however; patient must continue it along with his medicine:
- Avoid smoking, alcohol, spicy food, oily or preservative food.
- Keep skin hydrated
- Manage stress
- Avoid injuries to the skin.
