Dermatological Conditions - Lichen Planus

Lichen planus is a chronic (ongoing) mucocutaneous condition that can affect many areas of the body. It causes a non-infectious itchy rash. It is not contagious or is it hereditary. The condition gets its name from its appearance on the skin that resembles lichen formations in nature that are dry and undulating in appearance.
The areas of the body that can be affected by lichen planus include;

* The arms and legs

* The mouth (oral lichen planus)

* The nails and scalp

* The vagina, vulva and penis

When the condition affects the skin it results in reddish-purple bumps of 3-5mm which may have irregular white streaks on them. These bumps are known as papules. When thick, scaly patches appear around the ankle area this is referred to as hypertrophic lichen plans. The rash is usually causes some level of irritation. There is also a form of the condition that can affect the armpits and folds or creases in the skin. When the rash has gone there can also be a discolouration in the affected areas.

Oral lichen planus leads to a white pattern in the inner lining of the cheeks and across the tongue. There may be red and white patches in the mouth. It can also cause recurring mouth ulcers and pain in the gums.

Lichen planus can cause the nails to thin out and sometimes shed. It can cause ridges, thickening and discolouration of the nails and can also stop them from growing altogether. In the scalp it can cause redness in some areas and in severe cases can lead to permanent hair loss.

When it affects the vulva and vagina there it can lead to the appearance of red, white or pink streaks around the vulva. If the vagina is also affected there may be a sticky yellowish discharge that can be bloodstained. Sexual intercourse can be painful and the vaginal opening can narrow.

When the condition affects the penis it causes either purple or white rings to appear on the tip of the penis. Papules can also appear but the rash is not usually itchy.

The cause of lichen planus remains unknown and there is no known cure for the condition but there are treatments available that can be used to manage the symptoms for sufferers. Topical corticosteroid creams can be used to help treat and manage the swelling and irritation caused by the rashes. These are artificial hormone creams that are used in the treatment in a range of skin conditions. Once there is a colour change in the growths from purple to brown it is important stop using the creams as this is an indication that the inflammation has dissipated and if you continue to apply the creams it can lead to a thinning of the skin. The tablet form may also be prescribed in some cases.

Other forms of treatment include antihistamines, light treatment and acitretin. Oral lichen planus is not treated unless it is severe in which case there is a range of treatments available including mouth washes, gels, sprays and tablets that can all reduce the impact of the symptoms.
If you have any queries or concerns regarding lichen planus or any other skin related problems please do not hesitate to contact your doctor who will be able to advise you accordingly and refer you to a dermatologist if necessary.