TL;DR:
- Lichen planus is a non-contagious chronic disease affecting skin, nails, mucous membranes, scalp, and genital area. Oral lichen planus increases the risk of oral cancer.
- Common forms: nodular, vesicular, erosive, follicular, atrophic, and pigmented.
- Causes: Unknown but linked to autoimmune conditions (e.g., alopecia areata, vitiligo, diabetes), medications (e.g., quinine, gold salts), genetic predisposition, stress, hormonal changes, and skin trauma.
- Symptoms: Bluish-red shiny papules, itching, blisters, scarring, hair loss, nail defects, and white papules in the mouth/genital area. Oral lesions may lead to cancer.
- Treatment: Symptom management with corticosteroid ointments, antihistamines, retinoids, cyclosporine, phototherapy, and home remedies like cold compresses or dietary changes.
- Complications: Scarring, hair loss, vision loss, tear duct/esophagus constriction, and worsened appearance.
Lichen planus is one of the many emerging diseases of the skin and mucous membranes. It is a chronic condition that affects our physical appearance and mental well-being. Lichen planus can take many forms and appear in people suffering from specific diseases. So it's worth knowing what lichen planus looks like and what its causes and treatments are.
What is lichen planus?
Lichen planus is a chronic disease of the skin, nails and mucous membranes. It also affects the hairy scalp and can appear in the genital area. Particularly dangerous is the appearance of lichen planus in the oral cavity, as it can lead to the development of oral cancer. Cases of this disease have been reported worldwide. Lichen planus can take, form:.
- nodular,
- vesicular,
- erosive,
- follicular,
- atrophic,
- pigmented
Most often lichen planus is diagnosed in adults. However, this does not mean that children are not susceptible to the condition. It is also worth knowing that lichen planus is not contagious.
Causes of lichen planus
Although it is not a very rare condition, the causes that trigger the appearance of lichen planus have not been clearly identified. However, scientific observations suggest that lichen planus can appear due to an autoimmune substrate. This means that lichen planus can appear when immune system cells attack their own body. This is the case in people with alopecia areata, diabetes, acquired vitiligo, cirrhosis, and hepatitis and colitis. In addition, transplant patients who develop graft-versus-host – GVDH often develop skin lesions, including lichen planus. Studies have concluded that people who take certain medications are more likely to develop this condition. These include arsenic salts, quinine, penicillamine, paraaminosalicylic acid, and gold salts. ** Factors that increase the risk of developing lichen planus include chronic stress, hormonal changes, genetic predisposition, and skin trauma.**
Symptoms of lichen planus
Lichen can manifest itself in a number of ways, which depends, among other things, on the location of the lesion on the skin and its form. The most characteristic symptoms of lichen planus are visible papules on the surface of the skin. They take on a bluish red color and have a shiny surface. Sometimes blisters or blisters may also appear. The lesions on the skin may occur singly or in large numbers. In addition, they are accompanied by itching. Typically, lichen planus appears on the skin of the wrists, calves, ankles and lower back. In the case of lichen planus occurring on the hairy scalp, the main symptoms are red and irritated skin. Of course, small lumps can be felt, and hair is thin or falling out. Scarring may also appear. On the other hand, the symptoms of lichen on the nails are yellow furrows and defects in the nail plate. If lichen appears in the genital area, itching and white papules can be felt. The most dangerous is the appearance of lichen planus in the oral area, because then the chance of developing oral cancer increases. Oral lichen planus usually manifests as a white mesh that is located on the inside of the cheeks or on the tongue and gums. Lichen planus can cause redness as well as swelling and peeling of the mucous membrane. In some cases, painful ulceration occurs.
How to treat lichen planus?
Lichen planus is not difficult to diagnose. Therefore, if you notice characteristic symptoms, it is worth consulting a doctor. To determine the specific type of lichen planus, histopathological examination is used. The skin fragment taken is analyzed and evaluated under a microscope. Since the causes of the appearance of lichen planus are not fully known, the only treatment, is symptomatic treatment. Its main goal is to relieve the symptoms of the condition. However, it should be borne in mind that in 90% of people who develop impetigo planus, the symptoms disappear on their own after about six months, and in some cases persist for up to two years after its appearance. If lichen planus does not disappear without intervention, treatment is necessary, but it is important to bear in mind that in such a case it will be long-lasting. For the treatment of lichen planus, ointments containing glycocorticosteroids in their composition are primarily used. Sometimes this substance is recommended for oral use. The drug relieves itching and reduces skin lesions. In addition, the patient is given antihistamines, which also relieve itching of the skin. If the standard treatment is not effective, then slightly stronger drugs such as retinoids and cyclosporine are used. Phototherapy, which lightens the skin, may also be used. Also used to relieve symptoms are steroids and ointments with vitamin A, which accelerates skin healing. You may also be tempted to try home treatments for lichen planus. These include a proper diet that excludes citrus, tomatoes and products containing salt and caffeine. For lichen located in the mouth, a homemade rinse based on flaxseed or mallow can be prepared. A cold compress or a bath in water with oatmeal brings relief to itchy skin.
Complications
Lichen planus can cause sightless scarring affecting the appearance of the skin. In addition, in cases of erosive lichen planus, complications can include partial or even complete loss of vision, constriction of the tear duct and esophagus. Scarring of the skin on the head and within the vulva may also occur. Lichen that has appeared on the scalp contributes to hair loss, and baldness. That's why it's a good idea to consult a doctor about any worrisome skin lesion so that appropriate treatment can be started quickly and avoid the complications that the skin disorder lichen planus is associated with.
Conclusion
Lichen planus is a challenging skin and mucous membrane condition with diverse symptoms. While its causes remain unclear, factors like autoimmune issues, stress, and medications are linked. It can manifest in various forms, sometimes leading to severe complications like scarring or even cancer in oral cases. Thankfully, treatment options like corticosteroids, antihistamines, and phototherapy help manage symptoms effectively. Early medical consultation is essential to prevent complications and ease living with this condition. Be proactive—recognizing symptoms and seeking care can reduce its long-term impact significantly.
