A member of the lichen family of skin conditions, lichen planus is a non infectious rash that affects mainly the limbs, mouth, nails, scalp and genitals, but rare cases where the oesophagus and tear ducts are affected are known. The rash normally takes the form of itchy raised red or purple bumps, medically called papules, that measure around 3-5mm but can be up to 1cm in some cases. Sometimes the papules can also appear to have white streaks which indicate the ‘Wickham’s striae’ form of the disease, or thicker scaly patches normally around the ankles which indicate hypertropic lichen planus. When nails are affected, the skin becomes thin and grooved and in the mouth white patches can form. The cause of the condition is unknown, but recent medical thinking has linked it to an overactive immune system, triggered by a virus, which causes an excess of protein to be produced resulting in the skin becoming inflamed. Lichen planus could also occur as a reaction to certain types of medication such as gold injections and antimalarial tablets, as well as being linked to liver conditions such as hepititus.
It is estimated that one in fifty people are affected by lichen planus. It more commonly occurs in the over 40s, with the oral strain affecting more women than men. There is no definite cure for lichen planus, but treatments are available that can control the symptoms whichcorticosteroid creams, antihistamine creams and ultra-violet light. Corticosteroid creams are applied directly to the rash but treatment must be stopped once the colour of the rash changes from red or purple to brown or grey. Immune suppressant medication can be used in cases where it is thought that an overactive immune system is the cause and in severe cases corticosteroid or acitretin tablets can be prescribed on a short-term basis. In 50% of cases the rash clears up after six to eight months of it initially appearing, and in 85% of cases the rash disappears within eighteen months. However, erosive lichen planus can last for a very long time and causes painful ulcers in the mouth and genitals. In cases where lichen planus affects the mouth (oral lichen planus), mild symptoms often do not need to be treated but more severe cases normally require mouthwashes, corticosteroid sprays or tablets. Also, for one in five sufferers lichen planus reoccurs in the future, with a small number of people being affected several times by the condition over their lifetime.
More information about Lichen Planus is available through the Lichen Planus Support Group >
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