Lichen Planus

Lichen planus is an inflammatory condition that can affect the skin, mouth and genitals. Rows or clusters of dark, flat-topped skin lesions are typical of this condition. Being one of the chronic skin conditions, it tends to last for years in most cases.

Research conducted in 2008 at the Department of Oral Medicine, Tehran University of Medical Sciences clearly demonstrated the efficacy of a homeopathic drug Ignatia in the treatment of oral lichen planus. This is just one of the instances which has disbanded existing myths and proven homeopathy as victorious.

At Dr. Batra's, with our expertise and experience of treating more than 10,000 cases of Lichen planus in the last 35 years, we can assure our patients of good relief from this disease. Move on and experience the benefits of healing with this wonderful science!

What is Lichen Planus?

An inflammatory disease that affects almost 0.5 to 2 % of the world population, Lichen planus is an auto-immune condition that tends to run a chronic course. It presents with dark, raised lesions which are flat-topped mostly affecting the skin, but also involving the oral cavity and genitals in many cases.

Lichen planus skin disease which affects the skin, mouth and genitals

Lichen planus is neither infectious nor contagious in nature. Apart from being chronic, the disease has periods of remissions (when the symptoms disappear or reduce in intensity) and relapses (when the disease symptoms increase in intensity). Hence, patient compliance to conventional treatment is poor at times.

The disease can affect people of any age group though it tends to be common in young adults and middle ages. Children are less commonly affected and so are old people. Lichen planus affects females more commonly as compared to males.

On account of the etiology not being understood fully, conventional therapies tend to be more symptomatic in nature. However, homeopathy medicines have been demonstrated to have a significant impact on the psyche of the patients thereby giving rise to better results in the treatment of lichen planus.

Causes of Lichen Planus

What exactly causes Lichen planus has not been clearly understood till date but various theories have existed as to what can trigger this condition in some people and not in others. Some of the commonly cited reasons include:

  • An allergic or immune reaction to a medication or other substance has been strongly advocated as the cause for this condition. It's considered to be an auto-immune disease in which the body's protective cells attack the body's own tissues mistaking them to be foreign in nature.
  • Certain cases have been linked to infections such as hepatitis C
  • Quite a few drugs such as those containing arsenic, bismuth, gold can cause a reaction like the rash of lichen planus
  • Chemicals such as those used in the development of color photographs can also produce a similar rash
  • Long-term use of drugs like quinacrine or quinidine (anti-malarial drug) may produce hypertrophic lichen planus. Some other drugs that can trigger these kind of lesions include NSAIDs (Non-steroidal anti-inflammatory drugs), certain antibiotics (Dapsone, Penicillamine, Tetracycline, Sulfonamide), medicines to treat high blood pressure (Captopril, Propranolol, Methyldopa, Enalapril), Furosemide, Allopurinol, etc.
  • Stress - Intense and prolonged emotional stress such as sadness, anxiety, etc. can trigger an abnormal functioning of the immune system that can lead to Lichen planus.
  • Genetic cause
  • Amalgam dental fillings may trigger allergic reactions giving rise to oral lesions of lichen planus
Lichen Planus Symptoms

Lichen planus can be easily identified in most cases on account of the typical location of the spots and their characteristic 'violaceous' appearance.

The skin eruptions of lichen planus tend to involve:

  • Insides of the wrists
  • Ankles
  • Lower back
  • Scalp
  • Nails
  • Mucous membranes that line the mouth, nose, genitals (vagina / penis) and anus

The onset of the eruptions can be sudden or gradual and it shows the following features:

  • Rows or small clusters of flat-topped eruptions usually few millimeters in diameter
  • Violaceous color of rashes in most cases; the color may vary from purple to pink to red
  • Itching which may vary from mild to severe
  • New eruptions may appear at sites of minor skin injury such as a superficial scratch (called as Koebner's phenomenon)
  • In some cases, there may be thick, reddish-brown lesions that are covered with scales (called as hypertrophic lichen planus)
  • When the rashes resolve, they leave behind dark brown or gray spots (hyperpigmentation marks)
  • In cases of scalp involvement there can be development of scarring in affected areas leading to loss of hair (alopecia areata)
  • Nail affection may give rise to pits and grooves in the nails

Oral lichen planus has a typical presentation that involves:

  • Small, pale, raised areas that form a lacy network on the inside of the cheeks, rarely involving the tongue; occasionally the lesions may be red and shiny
  • Soreness, burning pain, tenderness - especially while taking spicy foods
  • Dry mouth with metallic taste or blunted taste sensation
  • Painful, recurrent ulcers in the mouth characterize one of the forms called erosive lichen planus

People with long-term lesions of lichen planus are at greater risk of developing malignancy (squamous cell carcinoma).

Variants of Lichen Planus

Lichen planus may present in different forms in different individuals. Certain variants respond better to treatment whereas others tend to be more obstinate. Depending on the presentation of the lesions (and their peculiar locations), following are the variants of lichen planus that have been described:

  • Hypertrophic lichen planus (Lichen planus verrucosus) - thickened lesions of lichen planus usually seen on the extremities, especially the shin. It tends to be very itchy in nature.
  • Atrophic lichen planus - a rare variant of lichen planus. It is characterized by plaques with central superficial atrophy.
  • Bullous or Vesiculobullous lichen planus - another rare variant of lichen planus. Vesicles and bullae (fluid-filled lesions) are seen along with the lesions of lichen planus.
  • Ulcerative lichen planus - is a rare variant of lichen planus. It presents with chronic, painful bullae and ulceration of the lesions.
  • Follicular lichen planus (or Lichen planopilaris) - affection of the hair follicles leading to scarring is seen. There is hair loss from the affected parts.
  • Lichen planus actinicus (Actinic lichen planus) - common in Middle East countries in spring and summer. Exposed areas of the face, dorsum of hands, arms and nape of the neck develop dark, lesions with rolled edges and well defined borders.
  • Lichen planus pigmentosus - another rare variant where dark-brown spots develop in sun-exposed areas and folds of the skin.
  • Annular lichen planus - Commonly involves the male genitalia but also has a predilection for folds of the skin such as the axilla and groin folds and marked by small clusters of lesions.
  • Linear lichen planus - lesions develop along a straight line, usually on extremities. May develop secondary to trauma (Koebner's phenomenon).
Diagnosis

The patient's symptoms, medical history and findings on examination are largely enough for the treating physician to diagnose lichen planus. Yet, there may be cases in which the early lesions resemble those of psoriasis or atopic dermatitis (in skin affection); leucoplakia or candidiasis (in oral affection), etc. A punch biopsy may be required in such cases to confirm the diagnosis or to rule out another condition. The skin biopsy is examined under a microscope and the tell-tale appearance of the lesions confirms the diagnosis.

In cases of oral lichen planus, in order to distinguish it from whitish precancerous plaques called leukoplakia, a biopsy of the oral lesions can be very valuable.

Lichen Planus Homeopathic Treatment

Homeopathy has proven efficacy in the treatment of lichen planus and this has been clearly demonstrated by clinical studies as well as cured cases. Recently, a research was conducted in 2008 at the Department of Oral Medicine, Tehran University of Medical Sciences to evaluate the effectiveness of Ignatia 30C (a homeopathic drug) in management of oral lichen planus (OLP). In this single-blind randomized control clinical trial, 30 consecutive patients with oral lesions consistent clinically and histologically with erosive and/or atrophic oral lichen planus were recruited. At the end of 4 months, the authors concluded that their results suggest that Ignatia has a beneficial effect in treatment of OLP in selected patients.

At Dr. Batra's, we have to our credit, the experience of treating more than 10,000 cases of lichen planus in our 35 years of practice. Today, we are in a position to offer significant relief to our patients and to relieve them from their suffering with the help of Homeopathy.

Homeopathic medicines target the altered immunity of the body and bring it back to normalcy over a period of time. The treatment helps in resolution of the existing lesions, reduces the itching and controls the further spread of the lesions. Unlike conventional treatment (which includes steroids), the homeopathic treatment tends to give lasting relief to the patients.

The response to treatment depends on various factors such as duration and severity of ailments, general health of the patient, and the extent of spread of the disease. Clinical experience suggests that Lichen planus of the skin alone is easier to treat as compared to one which is associated with oral and genital lesions.

Lastly, homeopathic medicines being completely safe and free from side-effects, can be taken by the patients without any worry of experiencing adverse reactions - they are also non habit-forming. Go ahead and experience the benefits of homeopathy and treat your lichen planus effectively, safely and gently.

Self Care Tips for Lichen Planus

At Dr. Batra's, we have treated a large number of patients of lichen planus and have made certain clinical observations to what helps the patients apart from the treatment and what can help them to prevent further outbreaks of this condition. Here are some of the valuable tips that can help you deal with lichen planus in an easier way:

  • Use cool compresses to control the itching
  • Keep your skin well hydrated - use oil or moisturizer over the lesions to prevent them from drying up as dry skin gets a lot more itchy
  • Avoid skin injury as new lesions tend to crop up at places of injury
  • Keep your nails short if your itching tends to be severe
  • Take adequate measures to control stress - practice yoga, meditation, etc.
  • If you know that you are sensitive to certain drugs that can cause lichen planus, make sure your doctor is aware of this. Let them prescribe you some alternative drugs whenever required.
  • Avoid drinking alcohol and using tobacco products if you have lichen planus in the mouth
  • Visit your dentist twice a year to check for oral cancer if you have oral lichen planus