Lichen Planus: Symptoms, Causes, Treatment

What are the symptoms of lichen planus?

Lichen planus is a chronic inflammatory skin condition that can affect various parts of the body, including the skin, mucous membranes, and hair follicles. The symptoms of lichen planus can vary depending on the location and severity of the condition, but common symptoms include:

Skin Symptoms:

1. Flat, itchy plaques: Red, flat, and itchy patches on the skin, often with a distinctive polygonal shape.
2. Warty lesions: Small, raised bumps or warts on the skin, often with a rough texture.
3. Scaly lesions: Dry, scaly patches on the skin, often with a red or pinkish color.
4. Nodules: Small, firm bumps on the skin that can be painful or tender to the touch.

Mucous Membrane Symptoms:

1. Blisters or ulcers: Blisters or ulcers on the mucous membranes in the mouth (oral lichen planus), genital area (genital lichen planus), or eyes (ocular lichen planus).
2. Redness and inflammation: Redness and swelling of the mucous membranes.
3. Pain or burning sensation: Pain or burning sensations in the affected areas.

Hair Follicle Symptoms:

1. Hair loss: Hair loss or thinning, especially on the scalp, face, and arms.
2. Scalp tenderness: Tenderness or pain on the scalp.
3. Follicular hyperkeratosis: Thickening of the skin around the hair follicles.

Other Symptoms:

1. Joint pain: Joint pain and stiffness in some cases.
2. Fatigue: General feeling of fatigue and weakness.
3. Weight loss: Unexplained weight loss in some cases.

It’s essential to consult a dermatologist for an accurate diagnosis and treatment plan if you’re experiencing any of these symptoms. Lichen planus is a chronic condition, and early treatment can help manage symptoms and prevent complications.

What are the causes of lichen planus?

The exact causes of lichen planus are not fully understood, but it is thought to be an autoimmune disorder, meaning that the immune system mistakenly attacks healthy tissues in the body. There are several theories about what may trigger the development of lichen planus, including:

1. Genetic predisposition: Lichen planus may be inherited, and certain genetic factors may make a person more susceptible to developing the condition.
2. Immunological factors: An imbalance in the immune system or an abnormal response to certain antigens may contribute to the development of lichen planus.
3. Hormonal factors: Hormonal changes, such as those experienced during pregnancy, menopause, or thyroid disorders, may trigger lichen planus in some individuals.
4. Environmental factors: Exposure to certain environmental toxins, such as pesticides or heavy metals, may contribute to the development of lichen planus.
5. Infections: Certain infections, such as hepatitis C or herpes simplex virus, may trigger lichen planus in some individuals.
6. Nutritional deficiencies: Deficiencies in nutrients such as vitamin B12 or iron may contribute to the development of lichen planus.
7. Stress: Stress may exacerbate symptoms of lichen planus, and some research suggests that stress may also contribute to the development of the condition.

It’s essential to note that lichen planus is a complex condition, and the exact cause is not yet fully understood. Further research is needed to determine the underlying causes and triggers of this condition.

In addition to these potential causes, there are also several risk factors that may increase a person’s likelihood of developing lichen planus, including:

• Family history: Having a family history of lichen planus or other autoimmune disorders
• Age: Lichen planus is more common in adults over 40 years old
• Sex: Women are more likely to develop lichen planus than men
• Ethnicity: Lichen planus is more common in people of African and Asian descent
• Other autoimmune disorders: Having a history of other autoimmune disorders, such as rheumatoid arthritis or lupus

If you suspect you have lichen planus or are experiencing symptoms similar to those described above, it’s essential to consult a dermatologist for an accurate diagnosis and treatment plan.

How is the diagnosis of lichen planus made?

The diagnosis of lichen planus is typically made through a combination of physical examination, medical history, and laboratory tests. Here are the steps involved in making a diagnosis of lichen planus:

1. Physical Examination: A dermatologist will conduct a thorough physical examination to look for signs of lichen planus, such as:
   • Lesions or patches on the skin
   • Blisters or ulcers on the mucous membranes
   • Hair loss or thinning
2. Medical History: The dermatologist will ask questions about the patient’s medical history, including:
   • Duration and progression of symptoms
   • Any previous treatments or medications
   • Family history of autoimmune disorders or lichen planus
3. Dermatoscopy: A dermatoscope may be used to examine the skin lesions and mucous membranes more closely.
4. Biopsy: A biopsy may be necessary to confirm the diagnosis of lichen planus. This involves removing a small sample of skin tissue for examination under a microscope.
5. Laboratory Tests: Laboratory tests may be ordered to rule out other conditions that may have similar symptoms, such as:
   • Complete Blood Count (CBC) to evaluate for signs of inflammation or infection
   • Liver function tests (LFTs) to assess liver health
   • Thyroid function tests (TFTs) to evaluate thyroid function
   • Skin scraping or biopsy for microscopic examination
6. Imaging Studies: Imaging studies such as X-rays, CT scans, or MRI scans may be ordered to evaluate for any underlying conditions that may be contributing to the symptoms.

The diagnosis of lichen planus is often based on a combination of these factors, including:

• Clinical presentation: The appearance of the skin lesions and mucous membrane involvement.
• Histopathology: The microscopic examination of skin biopsy tissue.
• Laboratory tests: The results of laboratory tests to rule out other conditions and evaluate for signs of inflammation or infection.

It’s essential to consult a dermatologist for an accurate diagnosis and treatment plan if you suspect you have lichen planus.

What is the treatment for lichen planus?

The treatment for lichen planus depends on the severity and location of the condition, as well as the individual’s overall health. The goal of treatment is to reduce inflammation, relieve symptoms, and promote healing. Here are some common treatments for lichen planus:

1. Topical corticosteroids: Creams or ointments containing corticosteroids can be applied directly to the affected areas to reduce inflammation and itching.
2. Topical immunomodulators: Creams or ointments containing immunomodulators can help reduce inflammation and slow down hair loss.
3. Oral antihistamines: Antihistamines can help relieve itching and reduce the allergic response.
4. Oral corticosteroids: In severe cases, oral corticosteroids may be prescribed to reduce inflammation and itching.
5. Retinoids: Derivatives of vitamin A, retinoids can help promote skin cell turnover and reduce inflammation.
6. Phototherapy: Exposure to specific wavelengths of light, such as ultraviolet B (UVB) or narrowband UVB (NB-UVB), can help reduce inflammation and promote healing.
7. Systemic medications: In severe cases, systemic medications such as methotrexate, cyclosporine, or mycophenolate mofetil may be prescribed to suppress the immune system and reduce inflammation.
8. Hair loss treatments: For hair loss related to lichen planus, treatments such as minoxidil (Rogaine) or finasteride (Propecia) may be prescribed to promote hair growth.
9. Laser therapy: Laser therapy can be used to stimulate hair growth and reduce inflammation.

It’s essential to work with a dermatologist to develop a personalized treatment plan that addresses your specific needs and symptoms.

Keep in mind that lichen planus is a chronic condition, and treatment may need to be ongoing for an extended period. With proper treatment, it’s possible to manage symptoms and prevent complications.