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lichen planus

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Lichen planus

Definition
Lichen planus is a skin disease that causes inflammation, itching, and skin lesions.

What is going on in the body?
Lichen planus is a rare disorder related to an allergic reaction. It is a skin eruption that produces scaly, purplish bumps with white lines or spots. It occurs most often in middle-aged people.

What are the signs and symptoms of the condition?
Symptoms of lichen planus may include:
  • flat, purplish, pimple-like bumps mostly on the wrists, lower back, shins, and sometimes the genitals
  • lace-like white lesions occurring in the mouth and on the mucosal surfaces of the genitals
  • itching
  • painful sores in the mouth and genitals
  • hair loss
  • abnormally thin or absent nail plates
What are the causes and risks of the condition?
The cause of lichen planus is unknown. This disorder may develop after exposure to certain medications, dyes, and chemicals, including:
  • gold
  • antibiotics
  • arsenic
  • iodides
  • chloroquine
  • quinacrine
  • quinidine
  • antimony
  • phenothiazines
  • diuretics
Symptoms become worse if a person feels stressed.

What can be done to prevent the condition?
There is no known way to prevent lichen planus. Avoiding certain chemicals and medications may reduce flare-ups in someone with this disorder.

How is the condition diagnosed?
A distinctive appearance of the skin and mouth lesions may indicate lichen planus. A biopsy of the lesions confirms the diagnosis.

What are the long-term effects of the condition?
Lesions that persist may be associated with hair loss and complete nail loss. Long-term erosive lichen planus within the mouth and the genital region has been associated with genital and oral cancer.

What are the risks to others?
Lichen planus is not contagious, and poses no risks to others.

What are the treatments for the condition?
If symptoms of the lichen planus are mild, no treatment may be needed. Treatment of lichen planus may include:
  • antihistamines to reduce the discomfort
  • liquid lignocaine mouth washes to numb the affected areas
  • topical corticosteroids, such as beclomethasone acetonide cream
  • corticosteroids, such as prednisone
  • topical vitamin A cream applied to lesions to reduce itching and inflammation
  • ultraviolet light therapy
What are the side effects of the treatments?
Side effects depend on the specific medications used, but may include drowsiness and allergic reactions.

What happens after treatment for the condition?
The skin lesions of lichen planus may clear up completely with treatment. Recurrence of lichen planus is likely when treatment is discontinued. Also, the degree and severity varies with each occurrence.

How is the condition monitored?
Erosive lichen planus of the oral and genital mucosa needs to be monitored closely, since these lesions are associated with oral and genital cancers. Any new or worsening symptoms should be reported to the doctor.

Author: Lynn West, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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