Lichen Planus

Lichen Planus is an itchy rash that usually presents on the inside of the wrists, forearms and ankles. Oral Lichen Planus specifically affects the mucous membranes that line the mouth, nose, and vagina – and usually shows up prior to any skin involvement.

Approximately 50% of the people exhibiting symptoms of this skin condition may also show symptoms of the oral variety as well. The initial attack can last for weeks, months, or years -- and may reoccur. The average duration of an occurrence is about four years. It does seem to affect more women than men, and usually occurs in middle-aged adults.

Symptoms

Usual skin involvement presents as rows of flat-topped, itchy lesions several millimeters in diameter that vary in color from pink, to purple to red. Itching can sometimes become intense. Bumps on the skin usually show up on the inside surfaces of the wrists, ankles and upper arm.

When located on mucous membranes, such as the mouth, nose or vagina, the most common form of this skin condition appears as light colored streaks or as smaller papules. Inside the mouth, symptoms can manifest on the mucosa, gingival, tongue, palate and lips.

The bullous form appears as small vesicles which protrude from the surface. The most severe form of the oral variety is referred to as Erosive Lichen Planus. In this instance, the affected area becomes inflamed (red) and ulcerated. Soreness or a burning sensation can accompany these symptoms. Long-term eruptions of the mucous membranes tend to put sufferers at a greater risk of the condition morphing into squamous cell carcinoma.

This skin disease can also attack the nails and scalp. In these situations, the nails can become grooved, thin or split. The scalp can become irritated and in some cases, hair loss may occur.

In the majority of cases, the cause of Lichen Planus remains unknown. There is thought in the medical community that it may be attributed to allergic or immune system reactions to certain types of medications (i.e. blood pressure, heart disease, arthritis). It may also be a complication of hepatitis C virus infections.

Treatment

In most cases, milder, more prevalent outbreaks do not require treatment - or self-treatment at most. However, treatment options do exist and can include:

• Topical Corticosteroids used to reduce inflammation and itching. Steroid injections are an option for thicker, localized lesions
• Antihistamines can be used to reduce the itching symptoms
• Oral Corticosteroids and Phototherapy such as PUVA can be prescribed in more severe cases
• Lidocaine mouthwashes can be used to provide temporary relief from pain associated with ulcerated lesions in the mouth

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