Lichen planus (patient information)
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# Overview
Lichen planus is a disease in which there is an itchy rash on the skin or in the mouth.

# What are the symptoms of Lichen planus?
- Mouth lesions:
- Tender or painful (mild cases may have no discomfort)
- Located on the sides of the tongue or the inside of the cheek
- Sometimes located on the gums
- Area of blue-white spots or "pimples"
- Lines of lesions that form a lacy-looking network
- Gradual increase in size of the affected area
- Lesions sometimes form painful ulcers
- Skin lesions:
- Usually located on the inner wrist, legs, torso, or genitals
- Itchy
- Even on both sides (symmetrical)
- Single lesion or clusters of lesions, often at sites of skin injury
- Papule 2 - 4 cm in size
- Papules clustered into a large, flat-topped lesion
- Lesions have distinct, sharp borders
- Possibly covered with fine white streaks or scratch marks called Wickham's striae
- Shiny or scaly appearance
- Dark colored - reddish-purple (skin) or gray-white (mouth)
- Possibility of developing blisters or ulcers
- Other symptoms include:
- Dry mouth
- Hair loss
- Metallic taste in the mouth
- Ridges in the nails (nail abnormalities)

# What causes Lichen planus?
- The exact cause of lichen planus is unknown. However, it is likely to be related to an allergic or immune reaction.
- Lichen planus generally affects middle-aged adults. It is less common in children.

# Who is at highest risk?
Risks include:
- Exposure to medications, dyes, and other chemical substances (including gold, antibiotics, arsenic, iodides, chloroquine, quinacrine, quinide, phenothiazines, and diuretics)
- Disorders such as hepatitis C

# When to seek urgent medical care?
Call your health care provider if:
- Your symptoms continue
- The skin or mouth lesions change in appearance
- The condition continues or worsens even with treatment
- Your dentist recommends adjusting your medications or treating conditions that trigger the disorder

# Diagnosis
- The health care provider may make the diagnosis based on the appearance of the skin or mouth lesions.
- A skin lesion biopsy or biopsy of a mouth lesion can confirm the diagnosis.
- Blood tests may be done to rule out hepatitis.

# Treatment options
- The goal of treatment is to reduce your symptoms and speed healing of the skin lesions.
- If symptoms are mild, you may not need treatment.
- Treatments may include:
- Antihistamines
- Immunosuppressant medications, such as cyclosporine (in severe cases)
- Lidocaine mouthwashes: to numb the area and make eating more comfortable (for mouth lesions)
- Topical corticosteroids (such as clobetasol) or oral corticosteroids (such as prednisone): to reduce swelling and suppress immune responses. :*Corticosteroids may be injected right into a lesion.
- Topical retinoic acid cream (a form of vitamin A) and other ointments or creams: to reduce itching and swelling and aid healing
- Topical immune-suppressing medications, such as tacrolimus and pimecroliumus but lesions must be watched carefully for signs of cancer
- Dressings may be placed over topical medications to protect the skin from scratching.
- Ultraviolet light therapy may be helpful in some cases.
- Oral retinoids (acitretin)

# Where to find medical care for Lichen planus?
Directions to Hospitals Treating Lichen planus

# What to expect (Outlook/Prognosis)?
- Lichen planus is usually not harmful and may get better with treatment. It usually clears up within 18 months.
- However it may last for weeks to months, and may come and go for years. It usually clears up within 18 months.
- If lichen planus is caused by a medication, the rash should go away once the medicine is stopped.

# Possible complications
Mouth ulcers that are there for a long time may develop into oral cancer.

# Source