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ichen planus is a relatively common, harmless, noncontagious, itchy rash that involves the skin and mucous membranes. Occurring most commonly in the middle years, it is characterized by reddish or violet-colored, firm, shiny, flat-topped, diamond-shaped “bumps” called papules.
The rash of lichen planus, occurring in about one percent of the population, is usually symmetrical in appearance and most often involves the inner surfaces of the wrists and forearms, the ankles, the genital areas, and the lower portion of the back. No area of the skin surface, however, is immune from this condition.
In the mouth, lichen planus can appear as a whitish or bluish-white, lacy-like pattern on the inner surface of the cheeks, or as whitish patches over the sides of the tongue. In rarer forms of this disorder, blisters or thickened warty areas may appear. In addition, one out of ten people with lichen planus have some type of nail changes, such as grooves, lines, distortion, or shedding of the nails.
The most characteristic symptom of lichen planus is itching. If there are only a few patches of the condition, the itching is usually mild. In the generalized form of the disease, however, the itching may become intense, causing loss of sleep, exhaustion, and despair.
The cause of lichen planus is unknown. It may be that it is not a disease at all – rather a symptom resulting from irritation, inflammation, or infection somewhere in the body.
Lichen planus can occur in people taking various drugs: high-blood pressure pills, antibiotics, and certain medications used to treat tuberculosis, malaria, and arthritis. The condition can also develop in workers in the photographic chemical industry following exposure to a type of color film developer. Many cases of resistant lichen planus occur in association with long-standing, untreated fungous infections of the feet (athlete’s foot). Since the onset of lichen planus occasionally coincides with some major emotional upset, it is often thought to be triggered by prolonged worry, anxiety, fatigue, shock, or other stressful situation.
Lichen planus can last for years, but as a rule, the greater the involvement, the shorter the course. Generalized and extensive eruptions last anywhere from two months to two years or longer. Localized eruptions, on the other hand, have a tendency to remain considerably longer. Unfortunately, recurrences are common, so one is never sure that the condition has disappeared permanently.
While fairly common, lichen planus is not a condition that is easily recognized and diagnosed by the person who is afflicted. Or by relatives, friends, or the friendly pharmacist. Only a physician, specifically a dermatologist, can make an accurate diagnosis, and while there is no specific therapy for lichen planus, your physician will know how best to treat the rash and the itching that accompany it.
Available treatments include various cortisone-like creams applied locally, certain antihistamine-tranquilizers taken orally, and cortisone-like injections into the patches of lichen planus. None of these, however, has shown more than limited success.
If you have a rash that has been diagnosed by your physician as lichen planus, be content to know that it is not contagious, infectious, serious, or malignant. Get as much rest as possible and avoid worry, tension, and fatigue. Maintain your general health and correct any hidden, internal infection you may have, such as abscessed teeth or infected gums.
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For further information about lichen planus, log on to: www.aad.org 1-888-462-DERM x22 or www.familydoctor.org/handouts/600.html |
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| TREATMENT OF LICHEN PLANUS |
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Itching is probably the most obvious symptom of lichen planus. It is also the most difficult symptom to control.
The localized patches are best managed with creams and ointments, and gels. Either of the following preparations may provide some symptomatic relief:
Cort-Aid Cream or
Cort-Aid Ointment
Directions for use are on the packages.
For the extensive or generalized variety of lichen planus, try
Sarna Lotion (Stiefel)
For the itching that invariably accompanies the rash of lichen planus, take either of the following antihistamines every 4 hours when necessary:
Chlor-Trimeton Tablets
Benadryl 25 mg
Directions and cautions on the labels.
For persistent, unmanageable itching, and when none of the above medications offers any relief, it is important to see your dermatologist.
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