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Lichen Planus

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Lichen Planus

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  • Dr. Michael Hiroshi Johnson
  • Updated 2024-08-22
  • Published 2024-03-07

Lichen planus – causes, symptoms, diagnosis, treatment, pathology

What is Lichen Planus?

Lichen Planus is a chronic inflammatory condition affecting the skin and mucous membranes. It causes itchy, flat, purplish lesions typically on the wrists, ankles, and lower legs, and can also affect the mouth, scalp, nails, and genitals.

What Causes Lichen Planus?

The exact cause of Lichen Planus is unknown. It’s thought to be an autoimmune reaction triggered by viral infections, allergens, stress, or genetics. Some medications for heart disease, high blood pressure, or arthritis may also trigger it.

How is Lichen Planus Diagnosed?

Diagnosis is based on the appearance of the rash and can be confirmed through a biopsy of the affected skin. A dentist can diagnose oral Lichen Planus by examining the mouth.

What are the Symptoms of Lichen Planus?

Symptoms include itchy, flat-topped, purple lesions, lacy white patches in the mouth, hair loss, nail damage, and blistering in severe cases. Oral Lichen Planus can lead to mouth sores and discomfort.

How is Lichen Planus Treated?

Treatment focuses on easing symptoms and may include corticosteroids, retinoids, antihistamines, light therapy, or immune suppressants. Oral Lichen Planus may require topical or systemic corticosteroids.

Can Lichen Planus be Cured?

There is no cure for Lichen Planus, but treatment can help manage symptoms and promote healing. The condition often resolves on its own within several months to a year, but recurrences are common.

Are There Complications Associated with Lichen Planus?

Potential complications include scarring, persistent painful lesions, especially in the mouth, increased risk of oral cancer with oral Lichen Planus, and emotional distress due to its chronic nature and appearance.

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Lichen Planus Symptoms

  • Itchy, flat-topped bumps
  • Purple-colored lesions
  • Raised, scaly patches
  • Skin rashes on the wrists, ankles, torso, or genitals
  • Mouth sores or ulcers
  • Hair loss
  • Nail abnormalities
  • Burning or painful sensation on the affected areas
  • Thin white lines on the inside of the cheeks
  • Difficulty eating or drinking due to mouth discomfort
  • Sensitivity to acidic or spicy foods
  • Changes in skin color or texture

Diagnosis Methods:

  1. Physical Examination: A dermatologist will visually inspect the affected areas to look for characteristic signs of Lichen Planus such as flat-topped papules, plaques, or white, lacy lesions on the skin or mucous membranes.
  2. Medical History: The patient’s medical history will be reviewed to identify any previous episodes of Lichen Planus or factors that may have triggered the condition, such as medication usage, recent infections, or exposure to certain allergens.
  3. Skin Biopsy: A small sample of the affected skin may be taken for laboratory analysis. A skin biopsy helps confirm the diagnosis of Lichen Planus by examining the microscopic characteristics of the skin cells.
  4. Patch Testing: If contact dermatitis is suspected as a potential trigger for Lichen Planus, patch testing can be performed. This involves applying small amounts of common allergens to the skin under a patch and observing for any allergic reactions.
  5. Blood Tests: Although there are no specific blood tests for diagnosing Lichen Planus, occasionally blood tests may be done to rule out other conditions that may present with similar symptoms, such as autoimmune disorders or hepatitis C.
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