Lichen planus is a disorder of the skin and mucous membranes resulting in inflammation, itching, and distinctive skin lesions.
Lichen planus is an uncommon disorder involving a recurrent, itchy, inflammatory rash or lesion on the skin or in the mouth. The exact cause is unknown, but the disorder is likely to be related to an allergic or immune reaction.
The disorder has been known to develop after exposure to potential allergens such as medications, dyes, and other chemical substances. Symptoms are increased with emotional stress, possibly because of changes in immune system during stress.
Lichen planus generally affects middle age adults. It is less common in children. The initial attack may last for weeks to months, and come and go for years.
Lichen planus may be associated with several other disorders, most notably hepatitis C.
Chemicals or medications associated with development of lichen planus include gold (used to treat rheumatoid arthritis), antibiotics, arsenic, iodides, chloroquine, quinacrine, quinidine, antimony, phenothiazines, diuretics such as chlorothiazide, and many others.
A preliminary diagnosis may be made on the way your skin or mouth lesions look. A skin lesion biopsy or biopsy of a mouth lesion can confirm the diagnosis. Additional blood tests may be done to rule out hepatitis.
The goal of treatment is to reduce your symptoms and speed healing of the skin lesions. If symptoms are mild, no treatment may be needed.
Treatments may include:
- Antihistamines
- If you have mouth lesions, lidocaine mouth washes may numb the area temporarily and make eating more comfortable.
- 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.
- Topical retinoic acid cream (a form of vitamin A) and other ointments or creams may reduce itching and inflammation and may aid healing.
- Occlusive dressings may be placed over topical medications to protect the skin from scratching.
- Ultraviolet light therapy may be beneficial in some cases.
Lichen planus is generally not harmful and may resolve with treatment, but can persist for months to years. Oral lichen planus usually clears within 18 months.
Long-standing mouth ulcers may develop into oral cancer.
Call your health care provider if symptoms persist, or if there are changes in the appearance of skin or oral lesions.
Call for an appointment with your health care provider if oral lichen planus persists or worsens despite treatment, or if your dentist recommends adjustment of medications or treatment of conditions that trigger the disorder.
Review Date:
10/16/2006
Reviewed By:
Michael S. Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
