1. What is lichen planus?
Lichen planus is an inflammatory disease that strikes primarily the skin and mucous membranes. In rare cases, it also affects the hair and nails. The causes of lichen planus are largely unknown. A few cases are linked to allergic reactions to specific drugs or dental materials. It affects men and women equally and occurs most often in middle-aged adults.
Lichen Planus of the Skin
1. What does it look like?
The rash is characterized by reddish-purple, flat-topped bumps that are usually very itchy. They can be anywhere on the body but seem to favor the inside of the wrists and ankles. The disease can also occur on the lower back, neck, genitals and in rare cases, the hair and nails. Thick patches may occur, especially on the shins.
2. What causes lichen planus of the skin?
The causes of skin lichen planus are not known. Allergic reactions to medications for high blood pressure, heart disease, and arthritis may cause lichen planus. In those cases, identifying and stopping use of the drug helps clear up the rash within a few weeks. Most cases of lichen planus go away within two years. About one out of five people will have a second attack of lichen planus.
3. How is lichen planus treated?
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. The two most common methods include the use of topical corticosteroid creams and antihistamine drugs taken by mouth. More severe cases of lichen planus may require stronger medications such as cortisone taken internally or a specific form of ultraviolet light treatment called PUVA.
Lichen Planus of the Mouth
1. Which areas of the mouth are commonly affected by oral lichen planus?
Lichen planus of the mouth most commonly affects the inside of the cheeks, gums and tongue. Oral lichen planus is more difficult to treat and typically lasts longer than skin lichen planus. Fortunately, most cases of lichen planus of the mouth cause minimal problems. About a third of all people who have oral lichen planus also have skin lichen planus.
2. What does oral lichen planus look like?
Oral lichen planus typically appears as patches of fine white lines. These changes usually do not cause symptoms. More severe forms of oral lichen planus can cause painful sores and ulcers in the mouth.
3. How is oral lichen planus treated?
There is no known cure for oral lichen planus. The good news is that the disease often causes no pain or burning and treatment may not be needed. More severe forms of oral lichen planus with pain, burning, redness, blisters, sores and ulcers can be treated with a variety of topical and oral medications.
4. Who is at risk for oral cancer?
When lichen planus is very severe, especially if the underside of the tongue is involved, there is a slightly increased risk of developing oral cancer. This risk is about twice that of the general population.
5. Should certain foods be avoided?
Spicy foods, citrus juices, tomato products, caffeinated drinks like coffee and cola, and crispy foods like toast and corn chips should be decreased or eliminated from the diet as they can aggravate lichen planus and interfere with its ability to heal.
Nail changes have been reported in about 10 percent of lichen planus cases. Usually only a few fingernails or toenails are involved, but occasionally all are affected.
In rare cases, lichen planus can affect hairy areas. This is called lichen planopilaris and can lead to inflammation, and in some cases to permanent hair loss.
Content courtesy of the American Academy of Dermatology