Lichen Planus: Diagnosis & Treatment

What is Lichen Planus?:

Lichen Planus is a common skin condition that often appears on the wrist, but can also appear on the scalp, lower back, ankles, nails, genitals and in the mouth. It is not contagious.

On the skin, lichen planus often causes bumps that are shiny, firm, and reddish purple. Sometimes the bumps have tiny white lines running through them.

Symptoms of Lichen Planus:

• Thick patches of rough, scaly skin. If bumps continue to appear in the same place, thick patches of rough, scaly skin can form. These patches develop with time and are most common on the shins and around the ankles.
• Itch. Sometimes the bumps and patches itch. The thick patches are most likely to itch.
• Blisters. These are rare.
• Pain, especially on the genitals. The skin can be bright red and raw. Open sores can appear. These can make sex painful or impossible.

What Causes Lichen Planus:

What causes most cases of lichen planus remains unclear. One theory is that lichen planus is an autoimmune disease. This means the person’s immune system reacts as though the skin and other parts of the body are foreign. When this happens, the body starts to attack itself. To find out whether lichen planus is an autoimmune disease, we need more research. Research leading to new treatment.

Some medicines can cause a rash that looks like lichen planus. These medicines include diuretics (treatment for high blood pressure and heart disease) and medicine taken to prevent malaria. Be sure to tell your dermatologist about every medicine that you take.

In the mouth, a metal filling may be the cause. This is rare, but it can happen. If this is the cause, replacing the metal filling with a non-metal filling will get rid of the lichen planus.

A rare type of lichen planus, familial bullous lichen planus, runs in families. Other forms of lichen planus do not seem to run in families.

There may be a link between lichen planus and infection with the hepatitis C virus. Many people with hepatitis C also have lichen planus. Your dermatologist may check to see whether you have this virus.

Treatment Options for Lichen Planus:

There is no cure for lichen planus. It often goes away on its own. If symptoms are bothersome, treatment often brings relief and may speed healing.

Treatment for the skin may include:

• Antihistamines: Pills that help alleviate itching
• Topical (applied to the skin) corticosteroid: Cream or ointment to reduce swelling and redness
• Corticosteroid: Pills (such as prednisone) or shots can help when lichen planus lasts a long time, or a patient has many bumps or painful sores
• Retinoic acid: Applied to the skin or given as a pill to clear the skin
• Tacrolimus ointment or pimecrolimus cream: Used to treat another skin problem, eczema

Treatment Outcome for Lichen Planus:

Many cases of skin lichen planus go away within two years. About one in five people will have a second outbreak. In some people, the skin problem may come and go for years.

As lichen planus heals, it often leaves dark brown spots on the skin. Like the bumps, these spots may fade without treatment. If they do not go away, dermatologists can lighten the spots with creams, lasers, or other treatments.

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