Lichen planus: Difference between revisions
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== Cause == |
== Cause == |
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[[Image:Lichen_planus.jpg|frame|Lichen planus]] |
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The cause of lichen planus is not known, however there are cases of lichen planus-type rashes (known as lichenoid reactions) occurring as [[allergic reaction]]s to [[medications]] for [[high blood pressure]], [[heart disease]] and [[arthritis]]. Lichen planus |
The cause of lichen planus is not known, however there are cases of lichen planus-type rashes (known as lichenoid reactions) occurring as [[allergic reaction]]s to [[medications]] for [[high blood pressure]], [[heart disease]] and [[arthritis]]. These lichenoid reactions are referred to as lichenoid mucositis (of the mucosa) or dermatitis (of the skin). Lichen planus has been reported as a complication of chronic hepatitis C virus infection. It has been suggested that true lichen planus may respond to stress, where lesions may present on the mucosa or skin during times of stress in those with the disease. Lichen planus affects women more than men 3:2, and occurs most often in middle-aged adults. Lichen planus in children is rare. |
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== Clinical features == |
== Clinical features == |
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The typical rash of lichen planus takes the form of well-defined, purplish, polygonal, extremely itchy bumps on the skin. The commonly affected sites are near the wrist and the ankle. The rash tends to heal with prominent blue-black or brownish discoloration that persists for a long time. Besides the typical lesions, many morphological varieties of the rash may occur. |
The typical rash of lichen planus takes the form of well-defined, purplish, polygonal, extremely itchy bumps on the skin. The commonly affected sites are near the wrist and the ankle. The rash tends to heal with prominent blue-black or brownish discoloration that persists for a long time. Besides the typical lesions, many morphological varieties of the rash may occur. |
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The presence of lesions is not constant and may wax and wane over time. |
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Inside the mouth, the disease may present in the (1) reticular form or in the (2) erosive form. |
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(1) The reticular form is the more common presentation and manifests as white lacy streaks on the mucosa (known as Wickham's striae) or as smaller papules (small raised area). The lesions tend to be bilateral and are asymptomatic. The lacy streaks may also be seen on other parts of the mouth, including the gingiva (gums), the tongue, palate and lips. |
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(2) The erosive form presents with erythematous (red) areas that are ulcerated and uncomfortable. The erosion of the thin covering of cells (the epithelium) may occur in multiple areas of the mouth, or in one area, such as the gums. Wickham's striae may also be seen near these ulcerated areas. |
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[[Image:Lichen_planus_nails.jpg|thumb|Lichen planus on nails (twenty-nail dystrophy)]] |
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== Differential Diagnosis == |
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The clinical presentation of lichen planus may also resemble other conditions, including: |
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* Lichenoid drug reaction |
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* Lupus Erythematosus |
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* Chronic Ulcerative Stomatitis |
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* Pemphigus Vulgaris |
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* Benign Mucous Membrane Pemphigoid |
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A biopsy is useful in identifying histological features that help differentiate lichen planus from these conditions. |
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Currently there is no cure for lichen planus but there are certain types of medicines used to reduce the effects of the inflammation. Lichen planus may go into a dormant state after treatment. There are also reports that lichen planus can flare up years after it is considered cured. |
Currently there is no cure for lichen planus but there are certain types of medicines used to reduce the effects of the inflammation. Lichen planus may go into a dormant state after treatment. There are also reports that lichen planus can flare up years after it is considered cured. |
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== Lichen planopilaris == |
== Lichen planopilaris == |
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[[Image:Lichen_planopilaris.jpg|thumb|Lichen planopilaris]] |
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Lichen Planopilaris is the specific name given to lichen planus on the [[scalp]] that may cause permanent, scarring [[alopecia]]. If left untreated the scarring will cause permanent hair loss. |
Lichen Planopilaris is the specific name given to lichen planus on the [[scalp]] that may cause permanent, scarring [[alopecia]]. If left untreated the scarring will cause permanent hair loss. |
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== External links == |
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* [http://www.lib.uiowa.edu/hardin/md/lichenplanus.html Links to pictures of Lichen planus (Hardin MD/Univ of Iowa)] |
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[[Category:Dermatology]] |
[[Category:Dermatology]] |
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Revision as of 22:52, 10 February 2006
Lichen planus is an inflammatory disease that usually affects the skin, the mouth, or sometimes both.
Cause
The cause of lichen planus is not known, however there are cases of lichen planus-type rashes (known as lichenoid reactions) occurring as allergic reactions to medications for high blood pressure, heart disease and arthritis. These lichenoid reactions are referred to as lichenoid mucositis (of the mucosa) or dermatitis (of the skin). Lichen planus has been reported as a complication of chronic hepatitis C virus infection. It has been suggested that true lichen planus may respond to stress, where lesions may present on the mucosa or skin during times of stress in those with the disease. Lichen planus affects women more than men 3:2, and occurs most often in middle-aged adults. Lichen planus in children is rare.
Clinical features
The typical rash of lichen planus takes the form of well-defined, purplish, polygonal, extremely itchy bumps on the skin. The commonly affected sites are near the wrist and the ankle. The rash tends to heal with prominent blue-black or brownish discoloration that persists for a long time. Besides the typical lesions, many morphological varieties of the rash may occur.
The presence of lesions is not constant and may wax and wane over time.
Inside the mouth, the disease may present in the (1) reticular form or in the (2) erosive form. (1) The reticular form is the more common presentation and manifests as white lacy streaks on the mucosa (known as Wickham's striae) or as smaller papules (small raised area). The lesions tend to be bilateral and are asymptomatic. The lacy streaks may also be seen on other parts of the mouth, including the gingiva (gums), the tongue, palate and lips. (2) The erosive form presents with erythematous (red) areas that are ulcerated and uncomfortable. The erosion of the thin covering of cells (the epithelium) may occur in multiple areas of the mouth, or in one area, such as the gums. Wickham's striae may also be seen near these ulcerated areas.
Lichen planus may also affect the genital mucosa. It can resemble other skin conditions such as atopic dermatitis and psoriasis.
Differential Diagnosis
The clinical presentation of lichen planus may also resemble other conditions, including:
- Lichenoid drug reaction
- Lupus Erythematosus
- Chronic Ulcerative Stomatitis
- Pemphigus Vulgaris
- Benign Mucous Membrane Pemphigoid
A biopsy is useful in identifying histological features that help differentiate lichen planus from these conditions.
Cure
Currently there is no cure for lichen planus but there are certain types of medicines used to reduce the effects of the inflammation. Lichen planus may go into a dormant state after treatment. There are also reports that lichen planus can flare up years after it is considered cured.
Medicines used to treat lichen planus include:
Lichen planopilaris
Lichen Planopilaris is the specific name given to lichen planus on the scalp that may cause permanent, scarring alopecia. If left untreated the scarring will cause permanent hair loss.