Lichen
planus is an inflammatory disease that
usually affects the skin, the mouth and sometimes
both. The cause of lichen planus is not known,
however there are cases of lichen planus-type
rashes (known as lichenoid reactions) occurring
as allergic reactions to medications for high
blood pressure, heart disease and arthritis.
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Lichen
planus has been reported as a complication
of chronic hepatitis B and C virus infection,
but it can occur for no reason and unrelated
to any underlying viral condition. |
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The
commonly affected sites are the buccal mucosa
in the mouth (the inner lining of the cheeks)
the wrist skin and the ankle skin. The rash
tends to heal with prominent blue-black or
brownish discoloration that can persist for
a long time if not treated. Besides the typical
lichen planus lesions, other varieties of
the rash may occur. |
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The
typical rash of lichen planus can be summarized
with 5 “P’s”:
Pruritic (itchy), Planar
(flat surface, like a plateau), Purple,
Polygonal (non-circular,
straight edges) Papules (small
raised skin bumps). |
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On
the contrary, when lichen planus occurs inside
the mouth, it looks like lacy white streaks
that overly bright red oral tissues. Inside
the mouth, the disease may present in the
reticular form or in the erosive form. The
reticular form is the more common presentation
and manifests as white lacy streaks on the
mucosa (known as Wickham's striae). The lesions
tend to be bilateral and are asymptomatic.
The lacy streaks can also be seen on the gingiva
(gums), the tongue, palate and lips. |
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Erosive
lichen planus presents with red areas in the
mouth or on the genital skin that are ulcerated
and uncomfortable. A biopsy is necessary to
differentiate lichen planus from other ulcerative
conditions of the mouth. |
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Currently there is no
cure for lichen planus but there are certain
types of medicines used to reduce the effects
of the inflammation (topical and oral steroids,
hydroxychloroquine, dapsone, topical and oral
immunosuppressant drugs). Lichen planus may
go into a dormant state after treatment. |
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Lichen
Planopilaris is the name given to
lichen planus when it occurs on the scalp.
Lichen Planopilaris may cause permanent, scarring
hair loss (alopecia). It initially presents
as a redness and scale around hair follicles.
If left untreated scarring occurs and creates
permanent hair loss. The treatments for lichen
planopilaris are the same as those mentioned
above for lichen planus. |
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