Dr. Schachter discusses Lichen Planus
What is lichen planus?
Lichen planus is a rash that's the result of inflammation. (Lichen refers to a growth commonly seen on trees, and planus is the Latin word for flat.)
The rash appears as small, flat-surfaced, multi-sided bumps that will sometimes merge and become scaly, rough patches on the skin. In addition, there can also be a rash in the lining of the mouth or vagina.
How does lichen planus differ from most other common skin rashes?
The major point of difference between lichen planus (versus eczema, psoriasis, and other common rashes) is its color-lilac or violet. Medical reference books refer to it as "violaceous."
What are the symptoms of lichen planus?
Lichen planus does itch, but at varying levels, depending on the patient. Some patients describe the itch as mild; other describe it as severe.
Lichen planus can appear suddenly or gradually. The initial episode may last for weeks or months, and further episodes may recur for years. (Children are not usually affected by lichen planus.) The first bumps will be small, 2 to 4 mm wide, with angular edges and a violet color. At the beginning of the condition, new bumps can develop at the location of a minor skin injury, like a simple scratch. Excess pigment may also appear in the affected skin.
How would you describe lichen planus?
The condition will appear differently, depending on the site affected, either the skin or the lining inside the mouth or vagina.
Skin:
The usual skin presentation consists of flat-topped lilac or violet spots a few millimeters wide. The spots will tend to show up on the inner wrists, the forearms, the lower legs just above the ankles, and the lower part of the back.
A variant of this disease is called hypertrophic lichen planus. This condition presents as thickened, reddish-brown lesions covered with scales. The spots will tend to be seen on the shins, but can appear at any place on the body. This is a particularly itchy and relentless version of lichen planus.
Mucous membranes:
Lichen planus of the mucous membranes is common. Dentists frequently come across it as a white, lacy rash on the inside of the cheeks in patients who don't yet know they have the condition.
About half of the cases of lichen planus appear inside of the patient's mouth. The oral rash can occurs before any skin condition develops.
More bothersome, although rare, is erosive lichen planus, which can be quite sore. This erosive variant usually causes the patient to complain of shallow but quite painful, recurring ulcers in the mouth.
Lichen planus can also affect the female genitals, including the vagina. The condition may sometimes be confused with sexually transmitted diseases (STDs), although lichen planus is neither sexually transmitted nor contagious.
Nails:
Sometimes, lichen planus may produce grooves or pits in the fingernails.
Dr. Schachter will be happy to answer any questions you may have about lichen planus.
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