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Lichen planus is a skin disease characterized by flat-topped purple or reddish-purple lesions that mainly affects the skin, but can also affect the mouth, genitals, scalp and nails. The most commonly affected sites are the inner wrists, forearms, and ankles. It occurs in both men and women of all races, but the condition occurs most often in middle-aged adults.

Symptoms

Lichen planus usually causes itchy, swollen rashes of small, flat reddish-purple bumps on the skin.  The rashes may also cause soreness and a burning sensation.  Once healed, they often leave patches of darker skin called hyperpigmentation.

In the mouth, lichen planus appears as white patches usually on the inner cheeks.  Occasionally, painful sores and ulcers also develop.

Permanent hair loss can occur if scalp involvement is present. 

Nail abnormalities such as brittle or split nails can occur if the nails are affected.

The disease is generally not harmful and although there is no cure, treatment can improve the condition.

Causes of Lichen Planus

Although the exact cause of lichen planus is unknown, it is likely related to an allergic or immune reaction. Certain medical conditions such as Hepatitis C, hypertension, diabetes and peptic ulcers may be associated with lichen planus. Lichen planus may develop after exposure to certain medications, dyes and other chemical substances. Some medications used to treat arthritis, high blood pressure, heart disease and malaria may trigger oral lichen planus. Stress may also worsen the condition.

Diagnosis of Lichen Planus

Your physician may diagnose lichen planus based on physical examination.  Sometimes, the physician will perform a biopsy of the skin to confirm the diagnosis.

Treatment of Lichen Planus

Medications can relieve the itching and help the rash get better.

  • Antihistamines (antiallergic drugs) and oral or topical corticosteroids are prescribed to reduce inflammation and relieve itching.
  • Topical retinoic acid cream (a form of vitamin A) may be used to reduce itching and aid healing.
  • Prescription mouthwashes may be ordered for oral lichen planus.
  • Patients with widespread or severe lichen planus may respond to ultraviolet light therapy