How To Manage Or Live With The Condition
You cant do much to prevent lichen planus, but once you have it, you can take steps to keep it from getting worse.
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Avoid injuries to your skin.
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Apply cool compresses instead of scratching.
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Limit the stress in your life.
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For oral lichen planus, stop smoking, avoid alcohol, maintain good oral hygiene, and avoid any foods that seem to irritate your mouth.
Lichen planus is not a dangerous disease, and it usually goes away on its own. However, in some people, it may come back.
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Common Symptoms For These People *:
* Approximation only. Some reports may have incomplete information.
Lichen Planus Of The Mouth
A dentist or doctor can diagnose oral lichen planus by looking at the inside of your mouth.
A biopsy may be recommended to confirm the diagnosis. A sample of mouth tissue will be removed so that it can be examined under a microscope. As with lichen planus of the skin, youll be given a local anaesthetic to numb the pain.
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Ease Lichen Planus Discomfort: 9 Natural Treatments
If you have a rash with red, purple or bluish lesions that itches and spreads, you may have lichen planus. This disease is triggered by the immune system in response to stress, allergens or a viral infection. It may affect the skin, scalp and nails, as well as the mouth and the genitals. Discomfort can range from mild to severe, and effective lichen planus treatments help to relieve the symptoms and facilitate healing.
As stated by the American Academy of Dermatology , while the rash is unsightly and uncomfortable, this condition is not considered serious, nor is it contagious. It can develop in one or more locations on the body. The medical community estimates it affects 0.1 percent to 4 percent of the general population, primarily between the ages of 30 and 60. As a matter of fact, lichen planus affects both men and women, but it most often occurs in women during perimenopause.
Lichen Planus Risk Factors
While no single, definitive cause has been determined, many medical conditions and environmental factors are believed to play a role.
- Genetics: Your risk for developing lichen planus is greater if a member of your immediate family has been diagnosed.
- Hepatitis C: Research has found a statistically significant association between hepatitis C and lichen planus as well as with a rarer form known as lichen planus pigmentosus.
- Allergens: Exposure to allergens including certain artificial dyes and chemicals may cause an outbreak.
- Medications: Certain medications containing arsenic, bismuth, gold or quinidine, including antibiotics, diuretics, medications for diabetes, malaria, high blood pressure and heart disease. A drug that causes a lichen planus eruption is known as a lichenoid drug.
- Bone marrow transplant recipient
- Age: It is most common in middle-aged adults perimenopausal women seem to be at a greater risk than other healthy members of the population.
- Amalgam Fillings: Fillings may act as an allergen leading to the development of oral lichen planus.
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Lichen Planus Of The Skin
The typical rash is small, red-purple bumps . The bumps are usually shiny and flat-topped . They vary in size from a pinhead to about 1 cm across. The number of flat-topped bumps that develop varies. The rash can appear anywhere on the body but is most likely to occur on the inner wrists, lower legs and lower back.
Fine white streaks often develop on the top of each bump. These are called Wickham’s striae.
The itch can range from mild to severe. A severe itch is common and is often the worst thing about lichen planus. The itch may disturb sleep and affect your quality of life. The itchiness is unusual in that affected people tend to rub the rash rather than scratch to ease the itch.
Sometimes the rash develops quickly over a few days. Sometimes each bump develops gradually over several weeks. Sometimes several bumps form in a line along a previous scar. Sometimes several bumps clump together to form a large patch. New bumps may appear over time as older ones are fading away. Each bump tends to last several months before fading away.
In most cases, the rash lasts between 6-12 months and then clears. In some cases it persists longer. A non-itchy brown or grey mark may be left on the skin where each bump had been. These may take several months or years to fade away completely.
What Are The Symptoms Of Lichen Planus
Lichen planus symptoms depend on where its affecting your body:
- Tiny, raised dots may develop on your skin, including your genitals. The dots are about the size of the tip of a pin , and they may grow to the width of a pencil . They may also develop into sores.
- Tiny white dots may develop on the skin inside of your cheeks, your tongue or your lips.
- Your nails may change colors, crack or split, stop growing or fall off.
Lichen planus doesnt hurt. However, if you scratch your rash, you may break your skin, leading to an infection that can cause pain.
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Study Sample And Procedure
The study was conducted on 42 patients with clinically and histologically confirmed oral lichen planus , who were treated in the Department of Periodontology, Division of Oral Pathology, of Wroclaw Medical University from 2012-2014. The approval for the research from Wroclaw Medical University Bioethical Commission was obtained. Inclusion criteria were: patients with diagnosis and history of oral lichen planus, without significant systemic diseases like: history of malignant diseases, hepatitis C infection and diagnosed psychiatric disorders. There was no dysplasia in histologically OLP tissues tested.
Patients age, duration of the disease understood as the time from beginning of symptoms or diagnosis of the disease until the day of clinical examination with exacerbations and remissions , presence of extra-oral skin manifestations and other mucosal and/or nail lichen planus lesions, as well as coexistent general disorders, were recorded. Subsequently, the psychological instruments listed below were administered.
Can Lichen Planus Be Cured
No, treatment controls the condition but does not cure it. However, in most patients lichen planus will heal within 18 months, and not return, although some patients may have further episodes many years later. Unfortunately, some types of lichen planus, such as those affecting the scalp, nails, mouth or genitalia, can last for many years. Even after active lichen planus has cleared, darker stains than the original skin colour may persist on the skin for a long time, particularly in Asian or Afro-Caribbean skin.
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Skin: Condition: Infomation Severe Or Widespread Lichen Planus
For severe or widespread lichen planus, the mainstay of treatment is with a course of steroid tablets. If there is little improvement in the rash, second line treatment with narrow band UVB therapy or acitretin may be considered. If there is a poor response to second line treatment, third line tablet treatments including methotrexate, and hydroxychloroquine can be considered. These drugs were not developed to treat lichen planus , but there is some evidence that they may be helpful. These treatments do not cure the rash and it is likely to worsen if they are stopped prematurely. Treatment must be carefully monitored with blood tests and like any medicine, the risks of harmful effects versus benefits need careful consideration by the Dermatologist and patient.
A Study Of Depression And Quality Of Life In Patients Of Lichen Planus
Neena S. Sawant
1Department of Psychiatry, Seth G.S. Medical College & KEM Hospital, Acharya Donde Marg, Parel, Mumbai 400012, India
2Department of Dermatology, Seth G.S. Medical College & KEM Hospital, Acharya Donde Marg, Parel, Mumbai 400012, India
Abstract
1. Introduction
Lichens are basically primitive plants composed of symbiotic algae and fungi. The term planus is Latin and it means flat. The British physician Erasmus Wilson was first to provide the name lichen planus as he first described it in 1869 and reported 6% of its prevalence in the general population. The characteristic appearance of lichen planus in the form of white striae that develops atop the flat surfaced papules was described by Wickham in 1895. Lichen planus is predominantly a disease of the middle aged and elderly population . The precise cause of lichen planus is still unknown and it is a psychocutaneous disorder which affects the skin, mucosa, hair follicles, and nails. It is also associated with psychoneuroendocrine and psychoimmunological comorbidities . Various viral, psychogenic, genetic, enzymatic, and immunological factors are listed as possible causes .
Brig et al. suggested that there is diversionary symbiosis between skin and psyche .
2. Methodology
2.1. Dermatology Life Quality Index
2.2. Becks Depression Inventory
All analyses were done with SPSS statistical version 17 at 5% significance.
3. Results
| Variables |
| 4 |
| Impairment in QoL as per total DLQI | Males |
4. Discussion
Limitations
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Are There Any Home Remedies For Symptoms Of Lichen Planus
There are several over-the-counter products or home remedies that can help stop your rash from itching.
While home remedies are safe for most people, its a good idea to check with your healthcare provider before trying some of the following options. You may be at risk of developing an allergic reaction.
- Aloe vera. Aloe vera is a wound care gel that can moisturize, heal and treat sores. Some research suggests that it can relieve lichen planus symptoms in your mouth or on your vulva.
- Antihistamines. Antihistamines are a class of drugs commonly used to treat allergy symptoms, including itchy skin.
- Hydrocortisone creams or ointments. Over-the-counter hydrocortisone is a corticosteroid combined with an anesthetic pain reliever.
- Oatmeal: Oatmeal contains gluten, which can soothe itchiness. The best way to use oatmeal on your lichen planus skin rash is to grind it into a fine powder in a blender or food processor. Mix the oatmeal powder with warm water until it becomes a thick, sticky paste. Apply enough of the oatmeal paste to cover your rash completely. After at least 10 minutes, wipe off the paste with a clean towel.
Stress can also make skin disease worse. There are mental/emotional signs of stress and physical signs of stress. Stress management techniques can help you prevent or ease your stress-induced lichen planus symptoms.
What mental/emotional signs and physical signs of stress can worsen my lichen planus symptoms?
Who Gets Lichen Planus
Lichen planus affects around one percent of the general population. Both men and women can get lichen planus. Skin lichen planus affects men and women equally, but oral lichen planus affects women twice as often as men. Although it may occur at any age, it usually affects middle-aged adults. It is uncommon in the very young and elderly. This disease can affect any individual all over the world, regardless of the race, skin color and culture.
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What Are The Symptoms Of Lichen Planopilaris
As with any disorder or disease, different people may experience different symptoms of LPP.
These are the most common symptoms:
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Scalp pain
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Itchiness of the scalp
Lichen planopilaris most commonly presents as smooth, white patches, and theres typically no hair in the patch area when on the scalp.
You may notice redness around the hair follicles around the edges of these bald patches.
Usually the areas of the scalp that are affected are either the front, sides or lower back .
What Exactly Is Lichen Planopilaris
As previously mentioned LPP is a skin disease that leads to scarring hair loss.
There are actually three types of lichen planopilaris:
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Classic Lichen Planopilaris: This skin disease is associated with inflammation of the hair follicles that leads to scarring and permanent hair loss.
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Frontal Fibrosing Alopecia: This form of LPP is identified by progressive hair loss that happens slowly and can cause scarring near the forehead. Occasionally, the eyebrows and eyelashes can be affected.
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Lassueur Graham-Little Piccardi Syndrome: Most commonly affecting women, this type of LPP leads to patchy scarring hair loss, thinning hair in the armpit and groin area, and rough bumps around the hair follicles.
LPP mostly affects adult women between the ages of 40 and 60, though men can get it, too.
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Family History Of Lichen Planus
A rare kind of lichen planus called familial bullous lichen planus is known to run in families. However, do keep in mind that other kinds of lichen planus do not appear to be hereditary.6
One study found that the shin is most commonly affected in familial bullous lichen planus, after which come the upper limbs and thighs. This kind of lichen planus tends to be chronic and progressive. It also usually doesnt involve the torso and the mouth.7
What Cause Lichen Planus
In most cases, the cause of lichen planus can’t be found. It is not caused by stress, but sometimes emotional stress makes it worse. This disorder has been known to occur after contact with certain chemicals, such as those used to develop color photographs. Some cases of lichen planus may be linked to chronic hepatitis C virus infection. This virus can cause serious liver diseases, such as liver cirrhosis and liver cancer. Your doctor may need to order a blood test to check for hepatitis C virus. In some people, certain drugs cause lichen planus. These drugs include medications for high blood pressure, heart disease, diabetes, arthritis and malaria, antibiotics, non-steroidal anti-inflammatory pain killers, etc. It is important to tell your doctor all the medicines you are taking. The rashes will go away after the offending drug is stopped. People who have lichen planus in the mouth may be allergic to certain products used during dental procedures, such as amalgam fillings. Patch testing may be used to specify the allergy removal of dental material is recommended and may result in cure.
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Oral Lichen Planus Causes
Doctors aren’t sure what causes oral lichen planus, but several things could play a part:
- It may run in your family.
- It could be linked to your immune system. Most of the time, your immune cells keep you safe by attacking bacteria and viruses. With oral lichen planus, some doctors believe, those cells get confused and attack the lining of your mouth.
- It could be linked to hepatitis C. Many people infected with the virus get it.
Correlation Between Anxiety Depression And Other Psychological Factors
The correlations between anxiety, depression and other psychological factors are illustrated in Table 4. Higher level of anxiety was significantly related to the use of catastrophizing as a coping strategy for pain and worse quality of life in all measured domains. Likewise, higher level of depression was strongly correlated with worse quality of life in subscales assessing anxiety , positive well-being , self-control , general health , vitality and general well-being .
Table 4
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What Is Oral Lichen Planus
Oral lichen planus is a long-lasting disease that affects your mouth with symptoms such as white patches, redness, and swelling. It doesn’t go away, but you can keep it under control.
Itâs not contagious, but anybody can get it. Women are more likely to have it than men. It’s most common in people older than 40. But kids and young adults can also get it.
Reaction To Metal Fillings In The Mouth
Though its rare, sometimes, metal fillings in the mouth have been known to cause oral lichen planus. More likely in women than men, and mostly caused in the middle ages, lichen planus can occur after you have got an amalgam dental filling. About 50% of amalgam dental fillings is made of mercury, and the mercury can cause a reaction.45 If this is so, substituting a non-metal filling for the metal filling will clear your lichen planus.
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The Correlation Between Sex Age General Health And Quality Of Life
The correlation analysis that examined the relationship between the patient’s age and quality of life revealed a significantly worse quality of life in older patients on the subscale of positive well-being . The patient’s sex had no effect on the general well-being, perceived stress or coping strategies for pain.
The higher number of general diseases in the study sample was related to a significantly poorer quality of life in terms of depression , positive well-being , self-control , anxiety , vitality and total general well-being . Moreover, a greater number of general diseases was correlated with a higher level of perceived stress and with a greater tendency to use catastrophizing as the coping strategy for dealing with pain. No correlation between the number of general diseases and other coping strategies for pain was observed.
What Causes Lichen Planopilaris
The exact cause of LPP is unknown. It is thought that it could be the result of an autoimmune issue.
The most commonly believed explanation is that white blood cells destroy skin and hair cells.
Generally, LPP is diagnosed via a physical examination and a microscopic look at a piece of tissue from the affected area taken through a punch biopsy.
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