Lichen planus

Lichen planus is an inflammatory disease that usually affects the skin , the mouth , or sometimes both. The onset may be gradual or quick, but its cause, like many skin diseases, is unknown. It appears to be a reaction in response to more than one provoking factor. It is thought to be due to an abnormal immune reaction provoked by a viral infection (such as hepatitis C) or a drug. Inflammatory cells seem to mistake the skin cells as foreign and attack them. It usually begins during midlife, between ages 45 and 60. But oral lichen planus can occur at any age, although it rarely affects children. Women are affected twice as often as men are. The condition appears to be related to lichen planus that occurs on the skin. There may also be a rash in the lining (mucous membranes) of the mouth or vagina. An initial episode of oral lichen planus may last for weeks or months, and recurrences may continue over many years. Oral lichen planus isn't an infectious disease and isn't contagious. Since it's not that common the condition is often mistaken for psoriasis because they can look similar. However, unlike with psoriasis, lichen planus is not believed to run in families and its onset bears no relation to stress.

It occurs most often on the inside of the cheeks, but can affect the gums, tongue, lips and other parts of the mouth. Occasionally oral lichen planus involves the throat or the esophagus. There are also drugs that produce lichen planus-like allergic reactions to high blood pressure, heart disease, and arthritis medications. The disease can occur anywhere on the skin, but often favors the inside of the wrists and ankles, the lower legs, back, and neck. But people with persistent mouth sores (lesions) are at increased risk of squamous cell carcinoma a form of skin cancer About 20 percent of the time lichen planus of the skin causes minimal symptoms and needs no treatment. However, in many cases the itching can be constant and intense. There is no known cure for skin lichen planus, but treatment is often effective in relieving itching and improving the appearance of the rash until it goes away. Lichen planus may cause a small number of skin lesions or less often affect a wide area of the skin and mucous membranes. In 85% of cases it clears from skin surfaces within 18 months but it may persist longer especially when affecting the mouth or genitals.

Causes of Lichen-planus

The comman Causes of Lichen-planus :

• Oral lichen planus can result from an allergic reaction to food, food additives, fragrances, dyes, dental metals or other substances
• Stress and anxiety often accompany oral lichen planus. However, it isn't clear whether psychological factors are the cause or the result of oral lichen planus.
• Certain medications, such as some of those used to treat arthritis, heart disease, high blood pressure and malaria, may trigger oral lichen planus in some people.
• Medical conditions associated with oral lichen planus include lichen planus of the skin, hypertension, diabetes and peptic ulcers.
• Some cases of oral lichen planus have been linked to infections, such as hepatitis C. Oral infections (such as an oral yeast infection called thrush) can lead to or intensify the symptoms.
• Oral lichenoid drug reactions may be triggered by systemic drugs including NSAIDs, beta-blockers, sulfonylureas, some ACE inhibitors, and some antimalarials. In patients with oral lichenoid lesions, be alert for any systemic drug as a cause.

Symptoms of Lichen-planus

Some comman Symptoms of Lichen-planus :

• Itching in the location of a lesion, mild to severe.
• Dry mouth.
• Hair loss.
• Ridges in the nails ( nail abnormalities ).
• Small, pale raised areas or bumps that form a lacy network on the tongue or inside the cheeks.
• Red, open sores in the mouth.
• A metallic taste or a blunted taste sensation.
• Usually located on the inner areas of the wrist, legs, torso, or genitals.

Treatment of Lichen-planus

• Occlusive dressings may be placed over topical medications to protect the skin from scratching.
• Topical corticosteroids (such as triamcinolone acetonide cream) or oral corticosteroids (such as prednisone) may be prescribed to reduce inflammation and suppress immune responses. Corticosteroids may be injected directly into a lesion.
• Infections sometimes associated with oral lichen planus, such as thrush, should be treated promptly. Screening for hepatitis C is warranted in all cases.
• Antihistamines
• If you have mouth lesions, lidocaine mouth washes may numb the area temporarily and make eating more comfortable.
• Topical retinoic acid cream (a form of vitamin A) and other ointments or creams may reduce itching and inflammation and may aid healing.
• If a medication seems to be causing the condition, your doctor may switch your medications.
• Treating medical conditions that you have, such as diabetes or hypertension, may improve your symptoms.
• Ultraviolet light therapy may be beneficial in some cases.

Women's Health

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