Lichen planus (LP) is a benign non-infectious skin problem which causes an itchy rash to show up on the skin or within the mouth. The reason is no well construed yet, yet it may relate come allergy or come immune reaction. The is present in 2% of people all end the world.
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Certain medicines such together gold, arsenic, iodides, and chloroquine, part dyes and other chemicals have actually all been linked with a greater incidence the lichenoid reactions, which are periodically thought to be a separate entity native lichen planus. LP is mostly uncovered to impact adults in their center age, and is infrequently uncovered in children.
LP produces dental or skin symptom in a proportion of 1:1. Dental lesions such together ulcers appear in a straight lacy arrangement. They might be bluish-white in color, and are one of two people painless or cause tenderness. These room thought to be autoimmune in origin, and are T-cell mediated, i.e. The cytotoxic CD8+ T cell bring around basal cabinet apoptosis in ~ the oral epithelium.
Skin sores usually appear on the inside of the wrists, the legs, the trunk and also the genital mucosa. Dark in color, they room itchy and well-demarcated from the surrounding normal skin. They may be glowing or scaly. Various other symptoms that LP encompass dryness of the mouth, ridging of the nails, and also alopecia.
Cutaneous LP shows up in various develops such as:Linear LPAnnular LPAtrophic LPHypertrophic LPErosive LP
Oral LP likewise takes different forms such as:ReticularPapularPlaqueAtrophicBullousErosive
Oral LP is accompanied by genital mucosal lesions in a 4th of patients. Together coexistence that oral and also genital alters is well-known as vulvovaginal-gingival syndrome in women and peno-gingival syndrome in men, and it harbors specific treatment challenges.
Complications that lichen planus
Erosive LP is a complication which reasons the development of ache ulcers ~ above the skin of the genital area and the mucosa that the mouth. Furthermore, the skin affected by LP may be hyperpigmented also after the lesion regresses.
Oral ulcers of very long standing have a higher risk of emerging into carcinomas the the mouth. Therefore, clinical attention should therefore be sought if:The figure of the lesions changesThe lesions do not respond come treatmentThe dental lesions are caused by treatable basic medical problems or by drugs
Diagnosis and treatment
Diagnosis is make on the basis of the characteristics oral and also cutaneous lesions. Biopsy that a lesion is confirmatory. Blood trial and error may be required to dominion out hepatitis C which can act as a precipitating element for LP.
Treatment is by medications to minimize pruritus, such as antihistamine pills, or corticosteroids the are provided topically or injected locally in the situation of hypertrophic lesions. Medicated antipruritic dressings are also used.
If the is resulted in by a medication, the offending drug have to be stopped at once. Tobacco and alcohol are to it is in avoided. Dental hygiene is to it is in insisted ~ above at every costs, and if local trauma is present, the cause (such as an ill-fitting denture) have to be investigated and corrected.
Potent corticosteroids such together clobetasol room first-line therapy for all forms of LP, and also may be provided topically, intralesionally or orally. ~ above the various other hand, calcineurine inhibitors such together tacrolimus room the 2nd line of treatment.
Certain retinoids or oral immunosuppressants are to be taken into consideration only because that severe and extensive LP. Carbon dioxide laser has actually been provided to vaporize lesions in painful oral LP, and also is both safe and effective.
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LP the the skin generally subsides spontaneously within a couple of years (especially the reticular form). However, recurrences are common, many notably in patients with erosive kind of the disease. Oral and genital LP may take much longer to regress.