Overview
Lichen planus (LP) may be a disease of the skin and, less often, the scalp, fingernails, toenails, and/or inside the mouth or genitalia (mucous membranes). lichen ruber planus can resolve on its own without treatment or be chronic, even with aggressive treatment. The explanation for the inflammation that results in lichen ruber planus is unknown.
Who's at risk?
People of all ages, of all races, and of both sexes can have lichen ruber planus . However, it's rarely seen in young children and older adults, most ordinarily occurring in people aged 30–60.
Although the explanation for lichen ruber planus is unknown, some people with the condition even have hepatitis C , an infection of the liver.
People who take certain medications may develop a rash that appears like lichen ruber planus (drug-induced lichen planus). These medications include:
Ø High vital sign (hypertension) medicines, including diuretics, ACE inhibitors, and calcium channel blockers
Ø Diabetes medications, including the sulfonylureas
Ø Ibuprofen or naproxen
Ø Antimalarial medications
Ø Gold
Ø Penicillamine
Ø Ketoconazole
Signs and Symptoms
The most common locations for lichen ruber planus include:
Ø Inner wrists
Ø Forearms
Ø Inner ankles
Ø Lower legs
Ø Neck
Ø Trunk
Ø Inside the mouth
Ø Fingernails and toenails
Ø Scalp
Ø Genitals
Individual lesions of lichen ruber planus on the skin appear as small (1–5 mm), flat-topped, red-to-purple bumps. As lichen ruber planus progresses, the surfaces of those bumps can become dry and scaly and may develop wispy, gray-to-white streaks (Wickham's striae). lichen ruber planus on the skin is typically itchy. New lesions of lichen ruber planus are often caused by injury (trauma). This so-called Koebner phenomenon may appear as a line of flat-topped, red-to-purple bumps on the skin. Once they heal, lichen ruber planus lesions often leave behind patches of darker (hyperpigmented) skin, which are more pronounced in darker-skinned people and which can take months to return to their normal color.
In the mouth, lichen ruber planus appears as white, net-like patches, most frequently seen on the inner cheeks. This oral lichen ruber planus doesn't usually cause symptoms, though severe outbreaks may develop painful sores and ulcers within the mouth. When lichen ruber planus involves one or more fingernails or toenails, it can appear as thickening, splitting, ridges, or grooves. In severe outbreaks, the whole nail could also be destroyed. On the scalp, lichen ruber planus (called lichen planopilaris) may cause redness, irritation, and, in some cases, permanent hair loss.
On the penis, lichen ruber planus appears almost like lesions on other areas of the skin. within the vulva or vagina, lichen ruber planus may appear as bright red patches or sores. Genital lichen ruber planus doesn't usually cause symptoms, but open sores could also be quite tender.
Self-Care Guidelines
Ø Apply over-the-counter hydrocortisone cream to assist relieve itching in mild lichen ruber planus .
Ø If you've got lichen ruber planus within the mouth, avoid drinking alcohol and using tobacco products. In severe outbreaks of oral lichen ruber planus , there's a really small chance of developing carcinoma , so you ought to see your dentist twice a year to see for carcinoma.
When to hunt medical aid
If you develop an itchy, bumpy rash, see a dermatologist or another physician for evaluation.
Treatments Your Physician May Prescribe
If lichen ruber planus is suspected, your doctor might want to perform a skin biopsy. The procedure involves:
Ø Numbing the skin with an injectable anesthetic.
Ø Sampling alittle piece of skin by employing a flexible razor blade, a scalpel, or a small kitchen utensil (called a "punch biopsy"). If a punch biopsy is taken, a stitch (suture) or 2 could also be placed and can got to be removed 6–14 days later.
Ø Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).
In addition, your doctor may recommend one among the subsequent treatments:
Ø Topical corticosteroid (cortisone) cream, lotion, ointment, or gel
Ø Topical tacrolimus or pimecrolimus
Ø Anti-itch lotions containing menthol, pramoxine, or phenol
Ø Corticosteroid (cortisone) injected directly into a thick lesion
Ø Oral antihistamine pills like diphenhydramine, loratadine, cetirizine, fexofenadine, desloratadine, or hydroxyzine for itching.
In addition, your doctor may suggest one among the subsequent treatments for oral lichen planus:
Ø Topical corticosteroid (cortisone) ointment or gel
Ø Topical cyclosporine solution used as a mouthwash
For very severe cases of lichen ruber planus , one among the subsequent therapies could also be recommended:
Ø Ultraviolet light treatment
Ø Oral retinoid pills like isotretinoin or acitretin
Ø Oral cyclosporine pills
Ø Oral hydroxychloroquine pills
Although there's no cure for lichen ruber planus , treatment can usually minimize symptoms and improve the looks of the rash until it heals.
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