Lichen Planus (LP) is a common inflammatory disease of the skin and mouth. It affects about one to two percent of the general population. Skin LP affects men and women equally, but oral LP affects women twice as often as men. LP occurs most frequently in middle-aged adults. The cause of LP is not known. While there are many theories to explain LP, most dermatologists believe it can be classified as an autoimmune disease. This means that white blood cells which usually fight germs begin to attack the normal parts of the skin, mucous membranes, hair, and nails. There are cases of lichen planus-type rashes which occur as allergic reactions to medications for high blood pressure, heart disease, and arthritis. Identifying and stopping the drug helps clear up the condition within a few weeks. Some people with LP can also have hepatitis C, and therefore the physicians will ask for bloodwork.
LP of the skin is characterized by reddish-purple, flat-topped bumps that may be very itchy. Some may have a white lacy appearance called Wickham’s Striae. They can be anywhere on the body, but seem to favor the inside of the wrists and ankles. The disease can also occur on the lower back, neck, legs, genitals, and in rare cases, the scalp and nails. While the typical appearance of LP makes the disease somewhat easy to identify, a skin biopsy may be needed to confirm the diagnosis.
LP of the skin usually causes few problems and needs no treatment. If there is severe itching there is a help. Many cases of LP go away within two years. As it heals, LP often leaves a dark brown discoloration on the skin. Like the bumps themselves, these stains may eventually fade with time without treatment. About one out of five people will have a second attack of LP.
There is no known cure for LP but treatment is often effective in relieving itching and in improving the appearance of the rash until it goes away. Since every case of LP is different, no one treatment is perfect. The two most common treatments include the use of topical corticosteroid creams, ointments, or other anti-inflammatory drugs, and antihistamines taken by mouth. More severe cases of LP may require stronger medications such as cortisone taken internally or a specific form of ultraviolet light treatment called PUVA.
There is no known cure for oral LP although there are many treatments that eliminate the pain of sores. When the disease causes no pain or burning, treatment may not be needed. More severe forms of LP – those with pain, burning, redness, blisters, sores, and ulcers – can be treated with a variety of medications, both applied to the sores (topical) and taken by mouth (oral). As with any disease of the lining of the mouth, LP can lead to poor dental hygiene and gum disease. Careful daily oral hygiene is very important. Schedule regular visits to the dentist for examinations and cleanings at least twice a year.