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Lichen planus and lichenoid eruptions : Treatment, symptoms, advice and help

About lichen planus and lichenoid eruptions

Lichen planus is a long-standing skin problem, which may also affect the nails and the hair. It is non-infectious in nature. Lichenoid eruptions refer to skin eruptions that are characteristically similar to lichen planus and arise due to auto-immune reactions against some medications.

Lichen planus and lichenoid eruptions: Incidence, age and sex

Lichen Planus is an uncommon skin condition that affects mainly the adult population. It is rarely seen in children. Its incidence is more in women as compared to men.

Signs and symptoms of lichen planus and lichenoid eruptions: Diagnosis

The skin lesions of lichen planus typically occur on wrists, ankles and the lower back. Sometimes, mouths and the genital areas may also get affected, in which case the lesions are longstanding and very difficult to treat. Lichenoid eruptions are similar to skin lesions of lichen planus, which present as purple-coloured papular rashes with distinctive white streaks across them. The arrangement of these skin rashes vary from linear to annular pattern. The affected individuals complain of intense itching over skin lesions. However, these skin lesions are typically non-contagious in nature.

The condition can be diagnosed on physical examination by a skin specialist. It is advisable to get a biopsy of the skin lesion done, not only to confirm the diagnosis but also to rule out any cancerous changes.

Causes and prevention of lichen planus and lichenoid eruptions

The exact cause of lichen planus is not clear. It may occur as an auto-immune reaction after a viral infection. Moreover, certain medications like anti-malarial drugs, gold or drugs used in arthritis, have also been known to cause such skin rashes; and such skin lesions are termed as lichenoid eruptions.

No specific preventive measures are applicable for lichen planus except for avoidance of certain medications (anti-malarial drugs, gold) in individuals with history of such skin eruptions.

Lichen planus and lichenoid eruptions: Complications

Lichen planus is a longstanding skin disorder, which may show persistence in cases of involvement of mouth and genitals. Very rarely, such lesions may show cancerous changes and present as squamous cell carcinoma of the mouth or the genitals. Furthermore, the affected skin may show greyish-brown discolouration as the skin rashes resolve. This is known as hyper- pigmentation of skin which is more prominent in dark-skinned individuals.

Lichen planus and lichenoid eruptions: Treatment

The treatment of lichen planus and lichenoid eruptions include corticosteroids, which may be given orally (in form of tablets) or topically (in form of creams, ointment or mouth wash).The treatment needs to be continued for about 1 to 2 months for effective results. If the individual is prescribed oral corticosteroids, it becomes important to monitor the adverse effects, if any. In some individuals, the skin lesions may show persistence in spite of corticosteroid treatment; other medications like immunosuppressant drugs may be prescribed for such individuals. However, lichen planus is a chronic skin problem, which also has a high propensity for recurrence.