Understanding Lichen Planus

A Comprehensive Guide to Symptoms, Diagnosis, and Treatment

Dermatology

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Last updated: Mar 24, 2025

What is Lichen Planus?

Lichen planus is an inflammatory condition that can affect your skin, hair, nails, and mucous membranes. It causes distinctive purplish, itchy, flat-topped bumps (papules) to appear on affected areas.

Key Symptoms

  • Skin manifestations:
    • Purple, flat-topped bumps
    • Intense itching
    • White lines on the bumps (Wickham's striae)
    • Most common on wrists, ankles, and lower back
  • Oral symptoms:
    • White, lacy patches in the mouth
    • Painful sores
    • Burning sensation
  • Other areas:
    • Nail changes or damage
    • Scalp involvement (can cause hair loss)
    • Genital area inflammation

Causes and Risk Factors

  • Exact cause unknown
  • Believed to be autoimmune-related
  • Potential triggers:
    • Hepatitis C infection
    • Certain medications
    • Stress
    • Allergic reactions

Diagnosis

  • Clinical examination
  • Skin biopsy when necessary
  • Blood tests to rule out other conditions
  • Hepatitis C screening

Treatment Options

Topical Treatments

  • Corticosteroid creams or ointments
  • Calcineurin inhibitors
  • Anti-itch medications

Systemic Treatments

  • Oral corticosteroids
  • Retinoids
  • Light therapy (PUVA)
  • Immunosuppressive medications

Self-Care Measures

  1. Avoid scratching
  2. Use mild soaps
  3. Apply cool compresses
  4. Maintain good oral hygiene
  5. Avoid spicy or acidic foods if oral symptoms present

Prognosis and Monitoring

  • Condition typically resolves within 1-2 years
  • Some cases may persist longer
  • Regular monitoring recommended
  • Increased risk of oral cancer in chronic oral cases

When to Seek Medical Care

  • Symptoms worsen or spread
  • Severe pain or discomfort
  • Oral lesions persist
  • New symptoms develop

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