Lichen planus (planopilaris) is a chronic and recurrent rash that is due to inflammation. It is a common skin disease that affects hairy areas of the body, causing inflammation, hair loss, and scarring. In some cases, it can lead to permanent hair loss. The skin condition produces small, shiny, flat-topped, itchy pink or purple raised spots found on the skin, genitals, the mouth as well as the scalp.
Lichen planus is a poorly understood skin condition. It is not an inherited disease or an infection and it is not related to nutrition nor is it contagious and not a form of cancer. It affects between 1 to 2% of the population and mostly middle-aged women.
Inflammation is not always present with lichen planus (planopilaris), which sometimes makes it hard to distinguish from other forms of scarring hair loss. In these cases, a skin biopsy may be required to diagnose the condition.
LICHEN PLANUS–PLANOPILARIS FACTS
- It affects about 1% – 2% of the general population.
- Lichen planus-planopilaris is a chronic recurrent rash of unknown cause with no established cure.
- It occurs in women more than men and may sometimes represent an allergic reaction.
- Lichen planus generally affects adults and can involve any portion of the body.
- It occurs more often in individuals pas the age of 50.
- Lichen planus can be quite itchy and eroded lesions usually burn and can be quite sore.
- Sometimes it appears to represent a reaction to medications, dental hygiene products,
chewing gum and candy or other substances that may touch mouth tissue.
- Stress may play a role in the outbreak of sores.
- Lichen planus is managed with a variety of the topical and oral medications.
- The white lesions of lichen planus are usually painless.
WHAT CAUSES LICHEN PLANUS-PLANOPILARIS?
The cause of lichen planus is unknown. Some experts theorize that it is an autoimmune disease causing a person’s immune system to react as though the skin and other parts of the body are foreign triggering the body to attack itself.
Symptoms can appear suddenly, or they may gradually develop, usually on the arms or legs. The lesions on the skin may be preceded by a dryness and metallic taste or a burning in the mouth.
Once the lesions appear, they change over time into flat, glistening, purple lesions marked with white lines or spots. Mild to severe itching is common. White, fine lesions are usually painless, but eroded lesions oftentimes burn and can be painful. As the lesions clear up, they usually leave a brown discoloration behind.
WHAT ARE THE SYMPTOMS AND SIGNS OF LICHEN PLANUS-PLANOPILARIS?
Lichen planus itches with an intensity that varies in different people from mild to severe. Symptoms are often absent but may include itching, pain, tenderness, discomfort or burning. The onset of lichen planus can be sudden or gradual and can last for weeks or months with recurrences appearing for years.
Usually in a typical case, physicians can make the diagnosis of lichen planus simply by looking at the rash. If there is a question in regards to diagnosis, a skin biopsy may be done to help confirm the diagnosis.
The diagnosis may be confirmed on a scalp biopsy that includes hairs with surrounding redness and scale at the edge of an area of hair loss. Lichen planopilaris is an example of a primary lymphocytic folliculitis. Read more…
TREATMENT | PROGNOSIS
Most cases of lichen planus are relatively mild with treatment focused on easing symptoms, It may take months to reach its peak, but it generally clears up within 18 months.