Lichen planus

What is Lichen Planus:
It is an autoimmune condition in which there is a chronic recurrent rash that is due to inflammation.Rash is characterized by small,flat topped,many sided bumps that can grow together into rough,scaly plaques on the skin .
There may also be rash in the lining (mucous membrane) of mouth and vagina.
Females are more frequently affected as compared to male

•It is considered to be an autoimmune disease in which the body’s protective cells attack the body’s own tissues mistaking them to be foreign in nature.
•Triggering factors are:
Hepatitis C infection
Hepatitis B vaccine
Flu vaccine
Certain pigments,chemicals and metals

•Slow onset
•Purpulish or flat topped bumps,most often on the inner forearm,wrist or ankle but sometimes on external genitals.
•Rough,oily look of lesions
•Bleeding may be present on scratching
•White spots or patches in the mouth (inside the cheeks or on the gums,lips or tongue),burning in mouth while eating spicy food.
Painful oral or vaginal ulcers
Hair loss and scalp discoloration
Nail damage or loss
•Lichen planus affecting nails-
It can affect nails in about 10% cases.The majority of nail changes results from damage to the nail matrix or nail root,Commonly two or three fingernails or toenails are involved.Nail changes are;
Longitudinal ridging and grooving
Nail thinning
Brown discoloration
Depression of the nail plate
Inflammation of proximal nail folds which becomes erythematou
Skin of fingertips shows a honeycomb appearance due to multiple,small,punctuate and hyperkeratotic depressions.

•Lichen planus hypertrophicus-It manifests as large, itchy, voilaceous ,hyperkeratotic papules and plaques on the anterior surface of legs.
•Lichen planus atrophicus-It presents as an annular area having atrophic,hyperigmented centre and active erythematous 1-2mm thick,raised border.usually seen on the face and dorsum of hands.
•Lichen plano-pilaris-It manifests as itchy,violaceous papules present at the openings of hair follicles.It results in loss of hairs.Commonly seen on legs and arms.
•Actinic lichen planus-In this annular grouped micropapular lesions are situated on the exposed parts of body like extensor sufaces of forearms and hands.They are aggravated on exposure to sunlight.
•Linear lichen planus-In this lesions of are distributed in a linear fashion.
•Bullous lichen planus-In this bullse are situated on the voilaceous base resembling lichen planus.

•Biopsy-During a punch biopsy test there is removal of small section of skin which is then examined under a microscope for cell patterns characterstics of lichen planus.
•Hepatitis C test-to determine is patient suffering from Hepatitis C,a possible triggering for lichen planus.
•Allergy test-To see any allergic reaction,which is a triggering factor for lichen planus.

•It first corrects immune reaction that is altered.
•Treatment helps in resolution of existing lesions,reduces the itching and controls the further progress of disease.
•Response to treatment also depends on severity ad duration of the disease.