Lichen Planus

Lichen Planus

Lichen planus is a T-cell mediated autoimmune disorder in which inflammatory cells attack an unknown protein within the skin and mucosal keratinocytes.

It is a common disease that causes inflammation (swelling and irritation) on your skin or inside your mouth.

Factors causing lichen planus may include:

• Genetic predisposition
• Stress (Physically and emotionally)
• Skin Injury
• Localized skin disease such as herpes zozter
• Systemic viral infection, such as hepatitis C
• Contact allergy, such as to metal fillings in oral lichen planus (rare) and colour photographic developers
• Drugs, gold, quinine, quinidine, and others can cause a lichenoid rash

Lichen planus is diagnosed clinically in most cases. A skin biopsy is often recommended to confirm the diagnosis.

• Avoid soaps and shower gels that will exacerbate scaling.
• Use emollients regularly.
• Sedating antihistamines may help you ease nocturnal itch.

Treatment is not always necessary as cutaneous LP can be self-limiting and treatment goals are to manage pruritus. Local treatments for the symptomatic cutaneous or mucosal disease are:

• Potent topical corticosteroids
• Topical immune modulators 
• Topical retinoids
• Intralesional steroid injections.

Systemic treatment for widespread lichen planus or severe local disease often includes a 1- to 3-month course of systemic steroids (eg, prednisone), while commencing another agent from the following: Acitretin, Hydroxychloroquine, Methotrexate, Azathioprine, Mycophenolate mofetil, and immune modular, and Phototherapy.