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Lichen Planus

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Lichen planus is a chronic recurrent inflammatory disorder of the skin and mucous membranes. It is characterized by small, flat-topped, polygonal bumps that may coalesce into rough, scaly plaques on the skin. There may also be involvement of the lining tissue (mucous membranes) of the mouth and/or vagina.


Lichen planus is a poorly understood skin condition. Its name is descriptive in that to some it resembles a simple plant, a lichen, which grows on rocks and tree bark, while planus is Latin for flat.

The onset of lichen planus can be sudden or gradual. The first attack may last for weeks or months, and recurrences may happen for years. The bumps at first are 2 mm-4 mm in diameter, with angular borders and a violet color. An excess of pigment (hyperpigmentation) may develop in the affected skin as the lesions persist. If lichen planus involves the scalp, it can permanently damage the hair follicles, producing a patch of bald skin called lichen planopilaris. If lichen planus involves the finger or toenails, scarring often occurs, producing permanently malformed nails. Ulcerative lichen planus may occur if oral or vaginal lining tissue (mucosa) are involved.
The cause of lichen planus is unknown. In certain locales, patients with extensive lichen planus seem to be more likely to have a hepatitis C virus infection of the liver. However, it seems unlikely that the virus is the cause of lichen planus in such situations.

Some drugs, such as those containing arsenic, bismuth, or gold, can produce an eruption which appears identical to lichen planus. Exposure to certain chemicals used in the development of color photographs can also produce a similar rash. The long-term use of the drugs quinacrine or quinidine (Quinidine Gluconate, Quinidine Sulfate), may produce hypertrophic lichen planus of the lower legs. Lichenoid eruptions can occur in graft-versus-host disease in people who have received bone marrow transplants. Tissue examination by a pathologist (biopsy) is frequently necessary to distinguish such lichenoid drug eruptions from classical lichen planus. Of course, stopping the offending drug is associated with resolution of the eruption.
https://www.medicinenet.com
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