Lichen planus

January 24, 2021Articles

Lichen planus is a cell-mediated immune response of unknown origin. It is a inflammatory condition of the skin and mucous membranes which could have several contributing factors and each case is different. Lichen planus is a condition that can cause swelling and irritation in the skin, hair, nails and mucous membranes. On the skin, lichen planus usually appears as purplish, itchy, flat bumps that develop over several weeks. In the mouth, vagina and other area covered by a mucous membrane, lichen planus forms lacy white patches, sometimes with painful sores. Lichen planus is not contagious.

Symptoms –

• Purplish- colored lesions or bumps with flat tops on your skin or genitals

• Itching at the site of the rash

• Blisters, which bursts and become scabby

• Lesions that develop and spread over the body over the course of several weeks or a few months

• Lacy-white lesions in the mouth, which may be painful or cause a burning sensation

• Thin white lines over the rash

The most common type of lichen planus affects the skin. Over the course of and spread. The condition usually clears up within 6 to 16 months.

Less commonly, the lesions can occur in areas besides the skin or genitals. These may include-

¤ mucous membranes

¤ nails

¤ the scalp

Causes –

Lichen plains occurs when your immune system attacks cells of the skin or mucous membranes. It is not clear why this abnormal immune response happens.

Lichen planus can be trigerred by –

• Hepatitis C infection

• Flu vaccine

• Certain pigments, chemicals like certain kind of dyes, iodide compounds and metals such as arsenic, gold.

• Pain relievers, such as ibuprofen and naproxen

• Certain medications for heart disease, high blood pressure

or arthritis

Risk Factors –

Lichen plans can occur in anyone at any age, but there are certain factors that make some people more likely to develop the condition. The skin form of lichen planus occurs in men and women equally, but women are twice as likely to get the oral form. It is very rare in children and older adults. It is most common in middle-aged people.

Diagnosis-

Your doctor makes a diagnosis of lichen planus based on your symptoms, your medical history, a physical examination and if necessary, the results of lab tests. There tests may include –

• Biopsy

• Hepatitis C test

• Allergy test

Treatment-

For mild cases of lichen planus, which usually clear up in weeks or months, you may not need any treatment. If the symptoms are uncomfortable or severe, your doctor can prescribe medication.

There is no cure for lichen planus, but medication that treat the symptoms are helpful and some may even be able to target a possible underlying cause. Medications often prescribed include-

• Retinoids ,which are related to vitamin A and are taken topically or orally.

• Corticosteroids reduce inflammation and can be topical, oral or given as an injection

• Antihistamines reduce inflammation and may be particularly helpful if your rash is triggered by an allergen

• Nonsteroidal Creams are applied topically and can suppress your immune system and help clear up the rash

• Light therapy treats lichen planus with ultraviolet light

Complications –

• Lichen planus can be difficult to manage on the vulva and in the vagina, causing severe pain and sometimes leaving scars.

• Sexual dysfunction can become a long-term complication.

• Oral sores may affect your ability to eat.

• Oral lichen planus increases the risk of oral cancer.

• Untreated lichen planus of the ear canal may lead to hearing loss.

• The affected skin might stay slightly darker even after the rest clears up, especially in dark-skinned people.

Ayurvedic Perspective –

Lichen planus is considered as a variety of Kustha resulted from dooshi visha or accumulated toxins. Ama get deposited in the skin or mucous membrane. Gradually this affect Vata, Pitta and Kapha components of skin and gradually manifest in to symptoms. Even though all the three Doshas involve in the pathogenesis, Pitta and Kapha dominate in Lichen planus.

Line of treatment-

• To detoxify the system by Shodhan or Panchkarma procedures

¤ Vamana