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Introduction
Lichen planus is a skin condition that causes itchy,
flat-topped bumps that develop into scaly patches.
Common sites of involvement are the flexor surfaces of
wrists, forearms, ankles, abdomen, and sacrum. Nails
may have ridges running lengthwise. Episodes of
disease activity, of which there are numerous
variations, may last for months and may recur. In more
extreme cases, patients are in pain, with erosions and
ulcerated areas.
Causes
The exact cause of lichen planus is unknown. It may be related to a
viral infection or a reaction to a chemical, such as
those used to develop color photographs. In some
people, certain drugs such as streptomycin,
tetracycline, gold, arsenic, bismuth, quinacrine,
quinidine, and quinine cause a reaction that looks
like lichen planus. Causes may have an allergic
reaction pattern, particularly following exposure to
dyes and color film developers.
Symptoms
Itching is mild to severe. The lesions are violet
colored, flat-topped, bumps or patches discrete or in
clusters, on the flexor surfaces of the wrists and on
the penis, lips, tongue, and buccal (mouth) mucous
membranes. The bumps can be extremely itchy. Areas of
skin affected by lichen planus may be discolored after
the condition heals. It is less common for lichen
planus to appear on the scalp and nails. When lichen
planus appears on mucous membranes, such as the mouth,
it usually has a white, lacy appearance.
Treatment
Your doctor can prescribe medication such as
antihistamines to relieve itching. Corticosteroids,
which can be injected into the affected areas, taken
by mouth, or applied to the skin, also help control
inflammation and itching. People with severe lichen
planus may benefit from psoralens plus ultraviolet A (PUVA)
treatment, which combines drugs to make the skin more
sensitive to ultraviolet light with phototherapy.
Medicated mouthwashes can help relieve pain from
ulcers in the mouth.
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