Lichen planus (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.

Lichen planus is a disease in which there is an itchy rash on the skin or in the mouth.

• Mouth lesions:

• Tender or painful (mild cases may have no discomfort)
• Located on the sides of the tongue or the inside of the cheek
• Sometimes located on the gums
• Area of blue-white spots or “pimples”
• Lines of lesions that form a lacy-looking network
• Gradual increase in size of the affected area
• Lesions sometimes form painful ulcers

• Skin lesions:

• Usually located on the inner wrist, legs, torso, or genitals
• Itchy
• Even on both sides (symmetrical)
• Single lesion or clusters of lesions, often at sites of skin injury
• Papule 2 – 4 cm in size
• Papules clustered into a large, flat-topped lesion
• Lesions have distinct, sharp borders
• Possibly covered with fine white streaks or scratch marks called Wickham’s striae
• Shiny or scaly appearance
• Dark colored – reddish-purple (skin) or gray-white (mouth)
• Possibility of developing blisters or ulcers

• Other symptoms include:

• Dry mouth
• Hair loss
• Metallic taste in the mouth
• Ridges in the nails (nail abnormalities)

• The exact cause of lichen planus is unknown. However, it is likely to be related to an allergic or immune reaction.

• Lichen planus generally affects middle-aged adults. It is less common in children.

Risks include:

• Exposure to medications, dyes, and other chemical substances (including gold, antibiotics, arsenic, iodides, chloroquine, quinacrine, quinide, phenothiazines, and diuretics)
• Disorders such as hepatitis C

Call your health care provider if:

• Your symptoms continue
• The skin or mouth lesions change in appearance
• The condition continues or worsens even with treatment
• Your dentist recommends adjusting your medications or treating conditions that trigger the disorder

• The health care provider may make the diagnosis based on the appearance of the skin or mouth lesions.

• A skin lesion biopsy or biopsy of a mouth lesion can confirm the diagnosis.

• Blood tests may be done to rule out hepatitis.

• The goal of treatment is to reduce your symptoms and speed healing of the skin lesions.

• If symptoms are mild, you may not need treatment.

• Treatments may include:

• Antihistamines
• Immunosuppressant medications, such as cyclosporine (in severe cases)
• Lidocaine mouthwashes: to numb the area and make eating more comfortable (for mouth lesions)
• Topical corticosteroids (such as clobetasol) or oral corticosteroids (such as prednisone): to reduce swelling and suppress immune responses. :*Corticosteroids may be injected right into a lesion.
• Topical retinoic acid cream (a form of vitamin A) and other ointments or creams: to reduce itching and swelling and aid healing
• Topical immune-suppressing medications, such as tacrolimus and pimecroliumus but lesions must be watched carefully for signs of cancer
• Dressings may be placed over topical medications to protect the skin from scratching.
• Ultraviolet light therapy may be helpful in some cases.
• Oral retinoids (acitretin)

Directions to Hospitals Treating Lichen planus

• Lichen planus is usually not harmful and may get better with treatment. It usually clears up within 18 months.

• However it may last for weeks to months, and may come and go for years. It usually clears up within 18 months.

• If lichen planus is caused by a medication, the rash should go away once the medicine is stopped.

Mouth ulcers that are there for a long time may develop into oral cancer.

http://www.nlm.nih.gov/medlineplus/ency/article/000867.htm

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