Lichen planus, a chronic inflammatory condition, manifests primarily on the skin, mouth, nails, and genitalia. While its exact cause remains elusive, researchers suggest a complex interplay of factors, including immunological or allergic reactions, exposure to certain medications, dyes, and chemicals, and even infections like Hepatitis C. The condition is not contagious and affects approximately 1% of the population, with a slightly higher prevalence among middle-aged men and women. While men and women experience skin lichen planus equally, oral lichen planus is more common in women. The condition is rarely seen in very young or very old individuals. Though not strictly seasonal, some forms, like actinic lichen planus, can be exacerbated by sun exposure and may be more noticeable during summer months. Interestingly, a slight uptick in lichen planus cases has been observed following the COVID-19 pandemic, potentially due to virus-triggered immunological changes, although the exact mechanism is still under investigation.
Lichen planus presents a range of symptoms depending on the affected area. Oral lichen planus often appears as lacy-white lesions accompanied by pain or a burning sensation. On the skin, the condition typically manifests as purplish, flat-topped bumps or lesions, often accompanied by intense itching. These lesions frequently appear on the wrists, lower back, and ankles, developing and spreading over several weeks or months. Thin, white lines may also be visible over the rash. Genital lichen planus can present similarly to the skin form, causing discomfort and potential complications. The chronic itching associated with lichen planus can significantly impact quality of life.
The treatment of lichen planus aims to alleviate symptoms and manage inflammation. For oral lichen planus, specialized mouthwashes and sprays can provide relief from burning and soreness. Topical corticosteroids, in the form of creams or ointments, are the mainstay of treatment for skin lesions, helping to reduce inflammation and itching. Oral antihistamines can further alleviate itching, and in severe cases, systemic corticosteroids may be prescribed. The specific treatment plan will be tailored by a healthcare professional based on the individual’s symptoms and the severity of the condition.
While lichen planus cannot be entirely prevented, measures can be taken to minimize its impact and prevent exacerbation. Protecting the skin from damage, including sun exposure, is crucial, especially for individuals with actinic lichen planus. Applying cool compresses can help to soothe itching and reduce the urge to scratch, which can further irritate the skin. Stress management techniques can also be beneficial, as stress can sometimes trigger or worsen symptoms. For oral lichen planus, maintaining good oral hygiene, avoiding irritating foods, and refraining from smoking and excessive alcohol consumption can help manage the condition.
If left untreated, lichen planus can lead to several complications. The persistent inflammation can result in chronic itching, discomfort, and painful sores. Scarring, particularly in the mouth and genital areas, is a potential long-term consequence. In severe cases, oral lichen planus can increase the risk of oral cancer. The pain and discomfort associated with the condition can also interfere with daily activities such as eating and sexual intercourse, significantly impacting quality of life.
The diagnosis of lichen planus is typically based on clinical presentation and a thorough physical examination. A dermatologist will evaluate the appearance and distribution of the lesions, considering the patient’s medical history and symptoms. In some cases, a skin biopsy may be performed to confirm the diagnosis and rule out other conditions. A biopsy involves removing a small sample of affected skin tissue for microscopic examination. This examination allows the dermatologist to identify the characteristic inflammatory changes associated with lichen planus, providing a definitive diagnosis. Once diagnosed, the dermatologist can develop a personalized treatment plan to manage the condition and minimize its impact on the patient’s well-being.
