Lichen planus is a dermatological condition that can occur on the skin and mucous membranes, causing inflammation and itching[1]. Understanding the causes of lichen planus is crucial in effectively managing and treating this condition. Several factors can contribute to the development of lichen planus, including genetic predisposition, emotional stress, hepatitis C infection, and allergies to substances such as mercury used in dental treatments. In addition, viral infections and certain medications have also been associated with the onset of lichen planus[3]. These various triggers emphasise the multifactorial nature of this skin disease and highlight the importance of comprehensive assessment and management strategies.

Patients with lichen planus often present with a range of symptoms that may vary in severity and localisation[4]. The lesions associated with lichen planus can spread to various parts of the body, affecting not only the skin but also the mucous membranes of the mouth and genital area[4]. In some cases, lichen planus may occur in rare locations such as the anus, auditory canal, eyelids and oesophagus[5]. The diverse presentation of lichen planus emphasises the need for a comprehensive understanding of the symptoms of the condition to facilitate accurate diagnosis and targeted treatment interventions.

Making a diagnosis of lichen planus typically involves a combination of clinical assessment and diagnostic procedures to confirm the presence of the disease[2]. Dermatologists can often diagnose lichen planus based on its characteristic clinical appearance, including distinctive lesions and patterns of inflammation[2]. However, in some cases, additional tests such as skin biopsy may be necessary to confirm the diagnosis and exclude other skin conditions. Patients may also undergo allergy testing to identify potential triggers or exacerbating factors associated with lichen planus[3]. By utilising a comprehensive diagnostic approach, healthcare providers can ensure accurate identification of lichen planus and tailor treatment plans to the specific needs of each patient.

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Treatment options for lichen planus

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Topical corticosteroids are often prescribed for the symptomatic treatment of lichen planus, a chronic inflammatory condition affecting the skin and mucous membranes[5]. These medications work by reducing the inflammation, itching and discomfort associated with the condition. Topical steroids are usually sufficient when the extent of the lesions is limited[6]. However, systemic corticosteroids may be necessary in more widespread or severe manifestations of lichen planus[1]. Despite the efficacy of corticosteroids in managing symptoms, it is important to remember that relapses may occur with dose reduction, emphasising the chronic nature of lichen planus[6].

Systemic medications become a very important treatment option for lichen planus when topical treatments and phototherapy are ineffective[4]. Oral corticosteroids are often considered in severe cases where other interventions do not yield satisfactory results. In addition, retinoid drugs derived from vitamin A and antihistamines may be prescribed as part of a systemic approach to the treatment of lichen planus[7]. Studies have shown that topical tacrolimus, a calcineurin inhibitor, can be as effective as corticosteroids in the treatment of oral lichen planus and offers an alternative option for patients[8].

Phototherapy, a well-established treatment method in dermatology, offers an alternative approach in the treatment of lichen planus[9]. This method involves exposing the affected skin to ultraviolet rays, which can help reduce inflammation and promote healing[10]. The widespread use of phototherapy for various skin conditions such as psoriasis, atopic dermatitis and vitiligo highlights its versatility and efficacy in dermatological care[10]. Especially for lichen planus, phototherapy using ultraviolet rays has shown promising results in improving symptoms and accelerating the healing process, making it a valuable treatment option for people with this challenging skin condition[3].

 

Frequently Asked Questions

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Q: What are the common causes of lichen planus?

A: Lichen planus can be caused by a variety of factors, including autoimmune reactions, genetic predisposition, infections, certain medications and even stress.

Q: What are the typical symptoms experienced by individuals with lichen planus?

A: Common symptoms of lichen planus include itchy, flat-topped, purple-coloured bumps on the skin, white, lacy patches in the mouth, and in some cases hair loss on the scalp.

Q: How is lichen planus diagnosed by health professionals?

A: Diagnosis of lichen planus usually involves a physical examination, review of medical history and possibly a skin biopsy or other tests to confirm the presence of the condition.

Q: What are the treatment options available to treat lichen planus?

A: Treatment options for lichen planus may include topical corticosteroids to reduce inflammation, oral medications for severe cases, and phototherapy as an alternative treatment approach.

Q: How can individuals effectively manage lichen planus and prevent possible complications?

A: Management of lichen planus includes using lifestyle and home remedies for symptom relief, scheduling regular follow-ups for monitoring with dermatologists, and being alert for any signs of complications or secondary infection.