All About Lichen Planus

Lichen planus is an autoimmune skin disease. It isn’t an infection, even if it tends to be mistaken as such. In this article, learn all about lichen planus.
All About Lichen Planus

Last update: 28 June, 2021

Lichen planus is an autoimmune skin disease that causes swelling in certain areas of the skin. This symptom has peculiarities that gave this disease its name. “Lichen” came from its resemblance to lichens that grow on vegetables, especially on tree trunks.

Lichens are fungi that grow in forests. Although it isn’t a fungal infection in humans, experts still gave the disease this name. On the other hand, the adjective “planus” is the description of the flat lesions that it causes in the skin, scalp, and mucous membranes.

The swelling turns tissues into bulky, flat surfaces. Lichen planus is quite common. Experts estimate that up to 1% of the world’s population suffers from it. It’s more common in women than men, and also more prevalent in white individuals.

The causes of lichen planus

An ibuprofen bottle.
Some drugs can trigger this disease.

Lichen planus is an autoimmune disease. This means that the immune system attacks its own cells because it doesn’t recognize them. In this case, the immune system attacks the cells of the skin and mucous membranes.

Although experts know that inflammation is an immune reaction, they still don’t know why it’s intrinsically triggered. They also don’t know why it occurs aggressively and it isn’t limited in time.

However, they have identified trigger situations that are associated with the onset of symptoms. Some of these situations are the following:

  • Exposure to some chemicals.
  • Drugs. For example, ibuprofen and cardiovascular system drugs.
  • Vaccines. Experts have associated influenza vaccination with lichen planus outbreaks.
  • Hepatitis C. Infected people usually have lichen planus lesions.

The symptoms this disease causes

The main symptom of this disease is purplish, flat bumps on the skin. These papules can appear in groups, forming plaques. They mostly appear on the upper limbs and ankles.

Along with inflammation, it also causes:

  • Itching
  • Ulcers and blisters. The former on the mucous membranes, and the latter on the skin.
  • Hair loss. This occurs when lichen planus affects the scalp.

Lichen planus can lead to the Köebner phenomenon, which is the development of isomorphic lesions in traumatized, previously normal skin.

Forms of presentation

Lichen planus doesn’t manifest in the same way in all patients. Experts have identified different forms of presentation:

  • Oral. It affects the oral cavity. In addition to inflammation, it causes ulcers on the oral mucosa that make feeding difficult. It isn’t easy to treat and can last for months. Oral lichen planus is associated with mouth cancer, so those who suffer from it should be examined regularly to prevent this evolution.
  • Warty. It usually appears on the legs. The lesions crust over.
  • Nail. In this case, the lichen affects the matrix in the nail unit.
  • Planopilaris. This type affects the hair follicles of the scalp. It leads to a form of alopecia or hair loss. It’s difficult to treat, like the oral form.

Read on to learn more: Tips to Prevent Skin Diseases

Available treatments for lichen planus

A dermatologist inspecting a patient's skin.
As lichen planus requires proper diagnosis, you should go see your dermatologist if you have any doubts.

There’s no curative treatment for this condition. Some types become chronic and very difficult to control, such as oral and planopilaris.

Thus, the goal of the medical professional is to control the patient’s symptoms. If the lesions are serious, doctors also seek to accelerate their healing.

Some of the therapeutic options are:

  • Immune system modulators. These are drugs that seek to reduce the inflammatory reaction.
  • Corticosteroids. As they’re good anti-inflammatory agents, medical professionals can prescribe oral or topical ones. You can also find corticosteroid injections on the market. Although they tend to cause adverse effects, sometimes, they’re the only symptom relief option.
  • Lidocaine. Oral mucosa lesions caused by lichen planus could interfere with proper feeding, which is why medical professionals sometimes prescribe local anesthetics such as swish.
  • Vitamin A creams. Vitamin A is perfect for nourishing the skin. Although it doesn’t relieve symptoms, it could aid healing and recovery.
  • Ultraviolet light (UV light). Ultraviolet light therapy sessions have shown beneficial effects. If the lichen planus is very widespread, the patient may require months of sessions.

A common condition that requires treatment

Lichen planus is a type of inflammatory and autoimmune disease that can affect different areas of the body, such as the mouth, nails, and scalp. A doctor will need to diagnose the patient before prescribing one treatment over another. Therefore, if you recognize the symptoms of this condition, go see a professional.

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  • Patterson JW. The lichenoid reaction pattern (‘interface dermatitis’). In: Patterson JW, ed. Weedon’s Skin Pathology. 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2016:chap 3.
  • Ingafou M, Leao JC, Porter SR, Scully C. Oral lichen planus: a retrospective study of 690 British patients. Oral diseases. 2006 Sep;12(5): 463-8.
  • García-Pola Vallejo, M. J., and J. M. García Martín. “Tratamiento del liquen plano oral: una revisión.” Avances en Odontoestomatología 24.1 (2008): 45-53.
  • Osnaghi Díaz Colodrero, Liset Eliana, et al. “Apoptosis y liquen plano oral. Revisión de la literatura.” (2017).