WHAT IS LICHEN PLANUS?
Lichen planus is an inflammatory condition triggered by the immune system which can affect skin, hair, nails and mucous membranes ( mouth, vagina etc). The exact cause of the immune system causing the condition is not known but it can occur after viral infection, allergen exposure, after stress or it could be due to family history as well. Sometimes lichen planus occurs along with other autoimmune diseases as well.
On skin lichen planus appears as purplish, flat topped rashes which are often very itchy. In mucous membranes areas like mouth and vagina, rashes appear as lacy white patches which are often sore. The condition is usually not serious unless it is painful with much itching. Lichen planus is not contagious.
As such there are no risk factors of development of lichen planus as it can occur at any age and can affect anyone but women are twice more susceptible to develop lichen planus and middle aged people are more likely to develop it.
It can be seen more in cases with viral infection (hepatitis C) , those who have history of allergen exposure (arsenic, gold, iodide compounds), due to stress or with family history of lichen planus, certain diuretics.
Lichen planus occurs when the immune system attacks the body cell so if you have any autoimmune disorder then you can develop lichen planus as well.
Lichen planus becomes troublesome when it involves much pain and itching. Sexual dysfunction occurs if lichen planus affects vulva and vagina as the area becomes painful and sensitive. Sometimes lichen planus can leave scar as well.
Hyperpigmentation may occur in some cases once the scar disappears.
Lichen planus may increase the risk of development of squamous cell carcinoma which is a type of skin cancer.
SYMPTOMS & CAUSES
Depending on the area affected the presentation of lichen planus may vary:
- Rashes which are purplish, flat topped.
- Itching on the rashes
- If lichen planus affects the vulva, vagina or mouth then the rashes appear as lacy white patches which are often sore and painful.
- Discolouration of skin
- Hair loss
- Nail become brittle and damaged
- Blisters may also appear on the site of rashes which can burst eventually and scab develops there.
Lichen planus occurs when the immune system mistakenly attacks the skin or mucous membrane cells. The exact cause of this immune attack is not known but there could be some triggering factors like:
- Hepatitis C infection
- Flu vaccine
- Certain medicines like diuretics
- Certain allergen exposure like arsenic, iodide etc
- Family history
DIAGNOSIS & TREATMENT
Diagnosis of lichen planus can be done on the basis of presentation of the symptoms. Certain lab tests could be done:
- BIOPSY: could be done to study the cell morphology for lichen planus
- ALLERGY TEST: can be done to see any allergen triggering immune reaction to cause lichen planus.
- HEPATITIS C: if viral infection is the triggering factor then doctor can do hepatitis c test.
Conventional treatment include relieving itching, pain and all symptoms by using corticosteroids, immunosuppressants, antihistamines. Underlying cause should be treated (hepatitis c infection, allergic reaction etc).
- NO SCRATCHING: patient should be advised not to scratch as it may lead to further infection and blister formation on the rashes
- COOL COMPRESSES: would help in relieving itching
- MOISTURISER: keep skin hydrated.
- SMOKING: advise on not to smoke should be given as it will make the oral lichen planus worse
- ALCOHOL: should not be consumed in case of oral lichen planus
- AVOID ALLERGENS: allergen which trigger lichen planus should be avoided
- NO SPICY OR ACIDIC FOOD: should be taken as it will aggravate oral lichen planus
- STRESS MANAGEMENT: advise on stress management should be given
- HEALTHY DIET: advise on healthy balanced diet including fresh fruits and vegetables should be given.
- HOMEOPATHY: homeopathy is an alternative system of medicine which can help get rid of lichen planus permanently without any steroid and topical ointment.
After a thorough case taking and analysis a homeopath can prescribe a medicine which can get rid of lichen planus permanently. Medicines like sulphur, pulsatilla, natrum mur, tuberculinum, ars alb etc can be used but only after constitutional study of the case.
DO’S & DON’TS
- Use cool compresses
- Keep yourself moisturised
- Manage stress
- Take healthy diet
- Drink plenty of water
- Avoid exposure to allergens
- Don’t smoke
- Don’t consume alcohol
- Don’t scratch