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What is Lichen Planus?

Signs and symptoms:

The typical appearance of the Lichen Planus eruption is round or irregular shape, raised slightly above the skin level, brown or pinkish or black in color.

Commonly Affected Parts in Lichen Planus

Lichen Planus largely affects the skin. It may also affect mouth (gums, tongue, palate) (oral Lichen Planus), the scalp, nails, or the genitals (glans, penis). It could affect one or more of the said body parts. It is not a rule that every patient with Lichen Planus will have all the said areas affected. In males, it could affect the glans of the penis and in females the vulva or vagina. It can

be said that more areas affected, more difficult to treat. Also, experience says that the oral or genital Lichen Planus is more difficult to treat as compared to that on the skin. Also, Lichen planus affecting the scalp when leads to scarring, may lead to permanent hair loss; which is difficult to treat.

Lichen Planus and Hepatitis:

Some of the latest studies have shown a co-association of Lichen Planus with a rare variety of Hepatitis-C. It may be noted that the exact connection and causative link has not been established between the two entities. It may be noted that patients with Hepatitis C have some proneness to develop Lichen Planus; the reverse is not true.

The typical textbook description goes :

Flat-topped shiny polygonal eruptions. Small in size, thickened eruptions, rough and/or oily to touch, dirty look at times. You may find spots either in groups, a few or numerous in number and very often bilateral symmetrical (on both the side of the body, say legs).
Clinically, a peculiar appearance classically described as Wickham's striae is considered diagnostic of Lichen Planus.

Causes of Lichen Planus

Lichen Planus is found to be an immunologically mediated disease. The exact cause of Lichen Planus is not very clearly understood. Some triggers have been found which are clinically found to be responsible for Lichen Planus. It is one of those conditions where the exact cause remains unknown till the date. There are theories. In some cases, there are obvious links with the facts such as

1. Modern Medicines

Certain modern medicines such as non-steroidal anti-inflammatory painkillers (NSAID), antihypertensive medicines, amalgamated dental filling, etc are known to induce Lichen Planus, which has a tendency to persist despite the discontinuation of the said medicines.

It may be of interest to list the common modern medicines which are known to induce Lichen Planus:

  • NSAIDs (Non-steroidal anti-inflammatory drugs)
  • Tetracycline
  • Captopril
  • Propranolol
  • Sulfonamide
  • Dapsone
  • Furosemide
  • Chloroquine
  • Penicillamine
  • Methyldopa
  • Enalapril
  • Allopurinol (anti-gout medicine)

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