Skin Lichen Planus, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Skin Lichen Planus, Diagnosis and Treatment and Related Diseases

Lichen Planus is a chronic inflammatory disease of the skin
It consists of red small papules which can cause itch and scratching
It is often associated with lesions of the mucosal membranes
Lichen Planus occurs more in women than in men

The cause of lichen planus may be related to an allergic or immune reaction
It is also associated with chronic hepatitis C virus infection
The typical rash of Pruritic, Planar, Purple, Polygonal, Papular
Microscopic appearance is hyperparakeratosis of the granular cell layer

The goal of treatment is to reduce symptoms and speed healing.
Dressings placed over skin medicines to protect from scratching
Topical Medicines include topical corticosteroids and Vitamin A cream.
More severe cases need oral corticosteroids, retinoids and Cyclosporine.

-An original poem by Kenneth Kee

Skin Lichen Planus is a chronic inflammatory disease of the skin which typically consists of red small papules that joined together to from rough scaly patches.
Lichen planus is a disorder that forms an itchy rash on the skin or in the mouth
Lichen planus is a poorly understood skin condition.
Its name describes that it resembles a simple plant, a lichen, which grows on rocks and tree bark, while planus is Latin for flat.
It is often linked with lesions of the mucosal membranes.
There are 2 main types:
1. Skin Lichen Planus is the most frequent type of Lichen Planus.
About 80% of people have red small papules that combined together to from rough scaly patches.
The skin normally grows very more quickly and is thicker than normal.
2. Mucosal Lichen Planus (small, red papular lesion of the mouth and mucous membranes)
Cause
The precise cause of lichen planus is not known even though it is immunologically mediated.
The initiating antigen is not clear;
Langerhans cells process the antigen to T lymphocytes, leading to an epidermotropic infiltrate.
Histologically, the inflammation is depicted as a lichenoid infiltrated effacing the dermo-epidermal junction.
Some patients with lichen planus have a positive family history.
It has been noticed that affected families have a higher frequency of human leukocyte antigen B7 (HLA-B7).
Others have determined a link between idiopathic lichen planus and human leukocyte antigen DR1 (HLA-DR1) and human leukocyte antigen DR10 (HLA-DR10);
It may be linked to an allergic or immune reaction
1. Allergic reactions to medicines for high blood pressure (methyl dopa), dyes, and other chemicals (including gold, antibiotics, arsenic, iodides, chloroquine, quinacrine, quinide, phenothiazines and diuretics.)
2. Chronic hepatitis C virus infection
3. Stress exacerbate the disorder
4. Allergic reactions to amalgam and gold filling can produce oral lesions
Symptoms
The start is sudden or gradual.
They may persist weeks or months and be repeat occurring.
Often they become chronic.
Skin rash
The typical skin rash of lichen planus is well-defined:
1. Pruritic,
2. Planar,
3. Purple,
4. Polygonal
5. Papular.
When seen under the microscope the papules have typical network of white lines (Wickham's striae)
Diagnosis
The doctor may make the diagnosis based on the appearance of the skin lesions.
A skin lesion biopsy can verify the diagnosis.
Direct immunofluorescence study shows globular deposits of immunoglobulin M (IgM) and complement mixed with apoptotic keratinocytes
Treatment
Lichen planus is a self-limiting disease that normally recovers within 8-12 months.
Medicinal therapies are:
Topical steroids
Systemic steroids
Oral metronidazole
Oral acitretin
Narrow-band or broadband UV-B therapy
PUVA
Immunosuppressants
Tacrolimus
TABLE OF CONTENT
Introduction
Chapter 1 Skin Lichen Planus
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Psoriasis (Updated)
Chapter 8 Pityriasis Rosea
Epilogue