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Lichen planus is a relatively common skin
disease that comes in episodes lasting months to years. The onset may
be gradual or quick, but its cause, like many skin diseases, is
unknown. It appears to be a reaction in response to more than one
provoking factor. Theories include stress, genetics, infective (viral
hepatitis C) and immunologic (autoimmune). There are also drugs that
produce lichen planus-like allergic reactions to high blood pressure,
heart disease, and arthritis medications. There is an inherited form
also which is often more severe and can have a protracted course.
Lichen planus appears as shiny, flat-topped bumps that often have
an angular shape. These bumps have a reddish-purplish color with a
shiny cast due to a very fine scale. The disease can occur anywhere on
the skin, but often favors the inside of the wrists and ankles, the
lower legs, back, and neck. The mouth, genital region, hair and nails
are affected in some individuals. Thick patches may occur, especially
on the shins. Blisters may rarely occur. Bumps may appear in areas of
trauma on some individuals. About 20 percent of the time lichen planus
of the skin causes minimal symptoms and needs no treatment. However, in
many cases the itching can be constant and intense.
This disease occurs most often in men and women between the ages of
30 and 70 years. It is uncommon in the very young and elderly. All
racial groups seem susceptible to lichen planus.
There is no known cure for skin lichen planus, but treatment is
often effective in relieving itching and improving the appearance of
the rash until it goes away. Since every case of lichen planus is
different, no one treatment does the job. Topical corticosteroids are
very useful. Antihistamines may be prescribed to relieve itching.
Extensive cases may require the use of oral corticosteroid (cortisone,
prednisone) for a number of weeks. This usually shortens the duration
of the outbreak. For severe cases powerful treatments include photo
chemotherapy light treatment (PUVA), the retinoids drugs (Soriatane and
Accutane), Neoral and Plaquenil.
Other helpful measures include soothing baths (Aveeno Colloidal
Oatmeal, Nutrasoothe) and the application of wet dressings (tap water,
Burows solution 1:40) to the affected areas to help reduce itching.
Also, the use of lotions containing anti-itch ingredients such as
menthol, pramoxine and phenol (Sarna, Aveeno cream, Prax, Itch-X) may
be helpful.
As it heals, lichen planus often leaves a dark brown discoloration
of the skin. Like the bumps themselves, these stains may eventually
fade with time without treatment. About one out of five people will
have a second attack of lichen planus.
http://www.aocd.org/skin/dermatologic_diseases/lichen_planus.html
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