Lichen planus is a chronic inflammatory skin condition that affects the skin, mucous membranes, hair, and nails. It is characterized by the development of small, flat-topped, polygonal bumps or papules that may be itchy, shiny, and purple in color. Lichen planus can occur at any age but is most common in adults aged 30 to 60 years. While the exact cause of lichen planus is not fully understood, it is believed to involve an abnormal immune response that triggers inflammation and damage to the skin and mucous membranes.
Symptoms: The symptoms of lichen planus vary depending on the location and severity of the condition. Common symptoms may include:
- Skin lesions: Small, flat-topped, shiny, purple or reddish-purple bumps or papules on the skin, typically on the wrists, ankles, lower back, genitals, or inside the mouth.
- Itching: The affected skin may be itchy or irritated, leading to scratching and potential worsening of the lesions.
- Oral lesions: White, lacy patches or lesions on the inside of the cheeks, gums, tongue, or palate, which may be painful or cause discomfort when eating or drinking.
- Nail changes: Grooves, ridges, pitting, or thinning of the nails, which may affect the appearance and texture of the nails.
- Scalp or hair involvement: Redness, scaling, or hair loss on the scalp, which may mimic other scalp conditions such as psoriasis or seborrheic dermatitis.
Types of Lichen Planus:
- Cutaneous Lichen Planus: Cutaneous lichen planus affects the skin and is characterized by the development of skin lesions or papules.
- Oral Lichen Planus: Oral lichen planus affects the mucous membranes inside the mouth and may cause white, lacy patches or lesions.
- Genital Lichen Planus: Genital lichen planus affects the genital area and may cause itching, irritation, or lesions on the genitals or surrounding skin.
- Nail Lichen Planus: Nail lichen planus affects the nails and may cause changes in the appearance and texture of the nails, such as grooves, ridges, or thinning.
Causes: The exact cause of lichen planus is not fully understood, but it is believed to involve an abnormal immune response that triggers inflammation and damage to the skin and mucous membranes. Potential triggers or factors that may contribute to the development of lichen planus include:
- Autoimmune factors: Lichen planus is considered an autoimmune condition, where the body’s immune system mistakenly attacks its own tissues.
- Genetic predisposition: Family history or genetic factors may increase the risk of developing lichen planus.
- Environmental factors: Exposure to certain medications, chemicals, allergens, or infections may trigger or exacerbate lichen planus in susceptible individuals.
Treatment: Treatment for lichen planus aims to relieve symptoms, reduce inflammation, and prevent complications. Treatment options may include:
- Topical corticosteroids: Corticosteroid creams, ointments, or gels may be applied to the affected skin or mucous membranes to reduce inflammation and itching.
- Oral medications: In cases of widespread or severe lichen planus, oral medications such as corticosteroids, retinoids, or immunosuppressants may be prescribed to help control inflammation and suppress the immune response.
- Phototherapy: Phototherapy involves exposing the skin to ultraviolet (UV) light, either in the form of narrowband UVB therapy or psoralen plus UVA (PUVA) therapy, to reduce inflammation and promote healing of lichen planus lesions.
- Topical calcineurin inhibitors: Calcineurin inhibitors, such as tacrolimus or pimecrolimus, may be used to reduce inflammation and itching in areas where corticosteroids cannot be used safely, such as the face or genital area.
- Oral retinoids: Oral retinoid medications may be prescribed to help reduce inflammation and promote healing of lichen planus lesions, particularly in cases of severe or refractory disease.
