Lichen Planus
know about Lichen Planus
Lichen planus (LP) is a chronic inflammatory disease of the skin, mucous membranes and nails and mucous membranes. Lichen planus lesions are so called because of their "lichen-like" appearance and can be classified by the site they involve, or by their morphology.
It is characterized by polygonal, flat-topped, violaceous papules and plaques with overlying, reticulated, fine white scale (Wickham’s striae), commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. Although there is a broad clinical range of LP manifestations, the skin and oral cavity remain as the major sites of involvement. The cause is unknown, but it is thought to be the result of an autoimmune process with an unknown initial trigger. There is no cure, but many different medications and procedures have been used in efforts to control the symptoms.
The term lichenoid reaction (lichenoid eruption or lichenoid lesion ) refers to a lesion of similar or identical histopathologic and clinical appearance to lichen planus (i.e., an area which resembles lichen planus, both to the naked eye and under a microscope). Sometimes dental materials or certain medications can cause a lichenoid reaction. They can also occur in association with graft versus host disease.
What can trigger Lichen Planus?
Lichen planus is a non-infectious, inflammatory skin disorder. The exact causes of lichen planus are not yet understood. People with hepatitis C are more susceptible to lichen planus.
Causes
The exact causes of lichen planus are still not known.
The exact cause of lichen planus is unclear.
Many believe it is an autoimmune disorder, where the immune system mistakenly attacks healthy tissues.
The following is known about lichen planus:
• It does not appear to be a hereditary condition.
• It is not an infectious condition
• It is not a form of cancer.
• It is not linked to nutrition. However, spicy foods, citrus juices, and tomato products may aggravate symptoms if there are open sores in the mouth.
Some causes of lichen planus are thought to involve the following:
Medications: Lichen planus can occur as a reaction to certain medicines, including:
• beta-blockers, which are common drugs used to treat cardiovascular problems
• anti-inflammatory medications
• gold injections for the treatment of arthritis
• antimalarials
• thiazide diuretics
• phenothiazines, a group of tranquilizing drugs with antipsychotic actions
Other substances: There is a link between contact with some chemicals used in color photographic development and lichen planus.
Mercury tooth fillings: Some studies have found a link between lichen-planus-type changes in the mouth and an allergic reaction to mercury tooth fillings.
Lichen planus can also be part of Grinspan's syndrome, a syndrome characterized by hypertension, diabetes, and oral lichen planus.
Why do you get Lichen Planus?
Lichen planus occurs when your immune system mistakenly attacks cells of the skin or mucous membranes. No one knows the exact cause of this abnormal immune response. The condition isn't contagious. In some people, certain factors, such as those below, may trigger lichen planus.
This "erosive" lichen planus causes painful sores and ulcers in the mouth. It's possible that about 1 percent to 5 percent of these cases may turn into oral cancer. ... It is probably the combination of these irritants over time along with erosive lichen planus that leads to oral cancer
On other hand Turmeric is better in reducing burning sensation, pain and white lesions. Conclusion: Turmeric and Tulsi both are effective in management of Oral lichen planus but turmeric is more effective in reducing burning sensation, pain and white lesions compared to Tulsi.
In most cases, the cause of lichen planus can't be found. It is not caused by stress, but sometimes emotional stress makes it worse. This disorder has been known to occur after contact with certain chemicals, such as those used to develop color photographs.
Managing Lichen Planus.
1. Limit stress. Stress can make lichen planus worse.
2. Try not to scratch. Covering the rash with a bandage can help.
3. Calm the itch. Applying a cool cloth or using an oatmeal bath treatment can help.
4. Try not to injure your skin. A skin injury can cause an outbreak where the skin was injured.
Most of the time, the bumps go away without any treatment after about a year. If symptoms are mild, no treatment may be needed. There is no known cure for skin lichen planus, but treatment is often effective in relieving itching and improving the appearance of the rash until it goes away.
These tests may include:
1. Biopsy. Your doctor removes a small piece of affected tissue for examination under a microscope.
2. Hepatitis C test. You may have your blood drawn to test for hepatitis C, which is a possible trigger for lichen planus.
3. Allergy tests.
On your skin, lichen planus causes a rash that is usually itchy. The cause of lichen planus is usually not known, although possible causes include: Hepatitis C, a virus that attacks your liver. Certain medicines, including some drugs used to treat high blood pressure, diabetes, heart disease, and malaria.
Lichen Planus Oral
Although it could indicate an immune disorder, more research is needed to determine the exact cause. It's possible that, in some people, oral lichen planus may be triggered by certain medications, mouth injury, infection, or allergy-causing agents such as dental materials. However, these causes are not confirmed.
Corticosteroids. The first choice for treatment of lichen planus is usually a prescription corticosteroid cream or ointment, to help reduce inflammation. If that doesn't help and your condition is severe or widespread, your doctor might suggest a corticosteroid pill, either alone or with the cream or ointment.
Patients with lichen planus were as old as those with psoriasis and in the general population at the time of death, but the diseases causing death differed. ... In recent years, however, its association with diseases that may have a poor outcome has been reported.
This "erosive" lichen planus causes painful sores and ulcers in the mouth. It's possible that about 1 percent to 5 percent of these cases may turn into oral cancer. ... It is probably the combination of these irritants over time along with erosive lichen planus that leads to oral cancer.
Conjunctival lichen planus can lead to irreversible damage to the ocular surface and loss of vision from corneal scarring. We report two patients with isolated lichen planus of the conjunctiva. The referring ophthalmologists had attributed these ocular findings to a severe dry eye state.
Lichen planopilaris (LPP) is an inflammatory condition that causes patchy hair loss, mainly on the scalp. ... Hair loss may be permanent if the disease causes permanent scarring (cicatricial alopecia). Treatment options may include steroids, isotretinoin or hydroxychloroquine.
After the bumps go away, they may leave a dark brown area on the skin. This is more likely to happen in persons of Asian, Hispanic or African heritage. These brown spots are not scars. They will slowly go away, but it may take many months.
