Lichen Planus

Lichen planus is a pretty common inflammatory disease that can affect the mouth or the skin. It causes specific oral or skin lesions. The two varieties are connected and people who suffer from the oral disease have a 50 percent chance to also develop skin lesions. The skin condition is normally very itchy. Scientists don't fully understand the root cause or the mechanism of lichen planus. It is an inflammatory disease that can sometimes progress very fast or quite slow. What is known for sure is that the disease is not caused by a pathogen, so it can't be transmitted. There is no risk of passing the condition to another person.

What are the signs and symptoms of lichen planus?

On the skin, lichen planus causes bumps to appear but these can have different features. They are usually small and flat and can be circular or with an irregular shape, red or purple in color. The number of bumps is variable, from a few to a large amount. They are covered with very small white scales, only visible after a closer inspection. They can also have the so-called Wickham's Striae, small streaks with a light grey color. The level of itching can be moderate or extremely intense but there are cases when the disease is not itchy at all. The disease can appear on any area of the body but it is usually found on the ankles, wrists and forearms.

Other areas that can be affected by the disease are the nails or the scalp. When it appears on the scalp, it can become red and inflamed, which leads to baldness in some cases. It can also emerge in areas where the skin is hurt, for example it is burned or has a minor cut or wound. The nails variety of the disease causes ridges all along them and makes them fragile and prone to splitting. The oral lichen planus causes white spots inside the mouth, which usually emerge on the tongue or the inner cheeks. These are usually harmless but in some rare cases they can become painful or turn into wounds that make eating difficult.

Another variant of lichen planus is the genital one, which affects the female organs. In this case, red zones or sores appear in the vagina or vulva and are easily mistaken for various sexually transmitted conditions. However, it should be clear that lichen planus is not such a disease and can't be transmitted in any way. While the open sores can be quite sensitive, this variety of lichen planus doesn't usually have other symptoms.

Cutaneous lichen planus

The skin type of lichen planus is further split into several different types, depending on the extent of the lesions and the area where they appear. In the Middle East, the most common areas affected are the extremities of the body, such as the arms, face, dorsal parts of the hands or the back of the neck. This variety seems to be triggered by strong sunlight, which is normal in the area during the spring and summer. Palms of the hands and soles of the feet are also possible locations.

The so-called inverse lichen planus emerges in areas where two areas of the skin rub together, such as the axila.

On the nails, lichen planus cause various irregularities. The nails can develop long marks and ridges, they can become thinner and sometimes the nail falls off leading to the atrophy of the nail bed. In medical terms, other symptoms can be subungual hyperpigmentation, subungual keratosis or the red marks known as longitudinal erthronychia. About 10 percent of nail lichen planus patients also develop rough nails, similar to sandpaper.

On the scalp, a rare variant of the disease is follicular lichen planus, also known as acuminatus, peripilaris or lichen planopilaris. Scales with a violet color appear on the scalp, causing hair loss and increasingly severe scars. This condition seems to be different from the normal lichen planus. They can even occur at the same time on the scalp and scientists have been unable to find a direct connection between the two diseases. Follicular lichen planus is a mystery disease with no clear cause and without any treatment, part of the so-called orphan diseases.

Other variants may include:

The lichen planus pemphigoides is a more sever variety of the normal disease, in which blisters develop over the normal lesions or on areas of healthy skin.

The so-called Nekam's disease, or the keratosis lichenoides chronica, is another rare type of skin disease. It causes violet lesions or a papular or nodular lesions to emerge on the extremities, buttocks or the dorsal hands and feet. These are sometimes arranged in a line or reticulate pattern. It can also have other symptoms, such as palmo plantar keratosis but also eruptions on the face and scalp that resemble regular dermatitis.

The benign lichenoid keratosis, also named the lichenoid keratosis or the solitary lichen planus consists of maculopapules covered in scales that can vary in color from red to brown. These usually cover the parts of the body that are exposed to sun. It is a persistent condition that can evolve into an isolated papular lesion, with a red or violet color.

Lichenoid dermatitis is an umbrella medical term for a variety of different skin problems that more or less resemble lichen planus.

What are the causes and risk factors?

Lichen planus is an auto-immune disease caused by the body attacking its own skin or mucous tissues. Like many other related diseases, nobody knows the real reason of this mistake.

While it can start at any age and affects all races, scientists have identified a few factors of risk. For some reason, women have twice the risk to develop the oral form of the disease, even if the skin variety is found in equal numbers of males and females. Middle-age people are the most likely to be affected, while it is rare in children.

Some other factors can also increase the risk of lichen planus. These include viral diseases such as hepatitis, contact with strong chemical allergens, or genetic factors, with a family history of the disease.

Some chemicals known to cause lichen planus are: diuretic drugs, antibiotics, some dyes, iodide compounds or arsenic.

Elma 01 Skin Ointment is very helpful in relieving symptoms of lichen planus.

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