Lichen Planus

Lichen planus is a chronic inflammatory condition that affects the skin and mucous membranes. It is characterized by the presence of purplish, itchy, flat bumps on the skin.

Causes and Risk Factors

The exact cause of lichen planus is not known, but it is believed to be an autoimmune disease, where the immune system mistakenly attacks healthy cells. Certain factors can trigger the onset of lichen planus, including:

• Hepatitis C infection
• Other viral infections
• Allergic reactions to medications or substances
• Genetic predisposition
• Stress

Symptoms

The symptoms of lichen planus can vary depending on the affected area, but common symptoms include:

• Purplish, itchy, flat bumps on the skin
• Lesions that are polygonal in shape and have a distinctive network of fine white lines (Wickham's striae)
• Oral lesions, which can appear as white patches or lacy lesions on the mucous membranes
• Vaginal lesions, which can cause itching, burning, and discomfort
• Nail changes, such as thinning or ridging of the nails
• Scalp involvement, which can lead to hair loss

Types of Lichen Planus

There are several types of lichen planus, including:

• Cutaneous lichen planus: affects the skin
• Oral lichen planus: affects the mucous membranes in the mouth
• Vaginal lichen planus: affects the vaginal mucosa
• Esophageal lichen planus: affects the esophagus
• Nail lichen planus: affects the nails
• Scalp lichen planus: affects the scalp

Diagnosis

The diagnosis of lichen planus is typically made based on a combination of clinical examination, medical history, and laboratory tests. These may include:

• Biopsy: to examine the affected tissue under a microscope
• Blood tests: to rule out other conditions and check for underlying infections or allergies
• Oral examination: to evaluate the presence of oral lesions

Treatment

The treatment of lichen planus depends on the severity and location of the condition, as well as the individual's overall health. Common treatments include:

• Topical corticosteroids: to reduce inflammation and itching
• Oral antihistamines: to relieve itching and discomfort
• Retinoids: to promote skin cell turnover and reduce inflammation
• Phototherapy: to reduce inflammation and promote healing
• Systemic corticosteroids: in severe cases, to reduce widespread inflammation

Complications

If left untreated, lichen planus can lead to complications such as:

• Scarring and skin discoloration
• Oral cancer: in rare cases, oral lichen planus can increase the risk of developing oral cancer
• Vaginal narrowing or scarring: in women with vaginal lichen planus
• Nail damage or loss: in cases of nail lichen planus

Prognosis

The prognosis for lichen planus varies depending on the individual and the severity of the condition. With proper treatment, most people can manage their symptoms and prevent complications. However, lichen planus is a chronic condition, and relapses can occur.