The skin is the most exposed organ to irritants, and when the body recognizes something as foreign, the immune system kicks into action. It produces what is known as antibodies against the foreign bodies (antigens). However, in many situations, the body produces antibodies against its own cells or tissue or components, causing an autoimmune reaction. One such autoimmune reaction is lichen planus, which is a skin rash caused when the body produces antibodies against its own skin or mucous membranes.
Risk factors: While anyone with a weak immune system can develop lichen planus, the followings increase the chances of that happening:
Presence of other autoimmune disorders
Hyperactive immune system, causing the allergic reaction
Increased stress levels
Prior history of viral infections
Middle aged women
Exposure to allergens like gold, arsenic, iodine, and drugs like diuretics and antibiotics
Prior history of hepatitis C
Symptoms: Diagnosis of lichen planus is quite easy, as it has a characteristic appearance.
Basically, a skin rash that is purple in color with flat tops on the skin
Rashes spread over the body in a matter of weeks
They are itchy, painful, and produce a burning sensation
Could have blisters which burst
Have thin lacy margin
Can be seen in the genital area, scalp, ankle, hands, mucous membranes, and nails
If required, a biopsy can be done in some cases to confirm the diagnosis. Allergy testing can also be done to confirm hyperactive immune system.
Treatments: This can depend on the severity of the condition. In people where it is not progressive or inflamed, it could be observed to run its natural course and subside.
For those requiring symptomatic treatment, the following can be used:
Steroids (topical or oral) to reduce inflammation
Antihistamines to reduce the allergic response
Retinoids (topical or oral) which can help overall skin health
Nonsteroidal creams to clear up the rash
Moisturizer to keep skin healthy and prevent dryness and itching
Cool compresses on the rashes
Loose clothing to prevent irritation and itching
Anti-itch creams and powders and lotions
Oatmeal bath to avoid itching and inflammation
Ultraviolet radiation to the rash to reduce severity
Avoid agents (drugs or chemicals) which can cause lichen planus
If the lesions are in the mouth, mouthwash and/or rinse can be used for topical relief
Lichen planus often does not require any treatment. However, depending on each individual, it may require topical and/or systemic treatment to manage the symptoms. It usually runs its course over 6 to 10 weeks and subsides on its own. If you wish to discuss about any specific problem, you can consult a Dermatologist.