Lichen planus is a disorder that causes changes to the skin and/or mouth.Lichen planus is NOT contagious.
It generally affects middle-aged men and women and is uncommon in children.
Many cases of skin lichen planus go away within 2 years. About 20% of people will experience a recurrence. In some people, the skin problem may come and go for years.
Lichen planus usually causes bumps that can be shiny, firm and reddish. The rash of lichen planus usually cause itching.
The bumps often appear symmetrically on both sides of the body, particularly the wrists, lower back, and ankles. However, they can appear anywhere, including the scalp and genitals.
New bumps may develop as older bumps fade.
The bumps of lichen planus may rarely develop into blisters.
Lichen planus commonly occurs inside the cheeks, on the tongue, lips, and gums. Symptoms may include the following:
Lichen planus in the mouth often lasts longer than lichen planus on the skin.
Lichen planus can affect the toenails and/or fingernails. It may affect just a few nails, or all the nails on one foot or hand.
The nails may appear with ridges or thinning. In some cases, the nail can stop growing altogether.
The exact cause of lichen planus is unknown. However, it is may be an autoimmune disorder caused by the body's own immune system attacking normal tissue in the skin and mouth.
People infected with hepatitis C also appear to be at greater risk of developing lichen planus.
Some medications, such as diuretics, can cause a rash that looks like lichen planus. Stopping the medication will lead to rapid improvement.
A skin biopsy or biopsy of a mouth lesion can confirm the diagnosis. Blood tests may be done to rule out hepatitis.
The goal of treatment is to reduce symptoms and speed the healing of lesions. Treatment may not be necessary in mild cases.
Treatments may include:
Your doctor will recommend a treatment plan based on the location of the lesions, the severity of symptoms, the presence of other medical conditions, and responses to past treatments.
As lichen planus heals, it often leaves dark brown spots on the skin called post-inflammatory hyperpigmentation. These spots usually fade over time without treatment, but there are treatments available that can lighthen them, including topical retinoids, chemical peels and laser/light treatments.
Mouth ulcers that persist for a long time are at risk of developing into oral cancer.
Image courtesy of Craig Heilman, M.D.