Lichen planus is an inflammatory disease that affects the skin and the oral mucosa, and presents itself in the form of lesions or rashes.
Cause of Lichen planus
The cause of lichen planus is not known; however, there are cases of lichen planus-type rashes (known as lichenoid reactions) occurring as allergic reactions to medications for high blood pressure, heart disease and arthritis. These lichenoid reactions are referred to as lichenoid mucositis (of the mucosa) or dermatitis (of the skin). Lichen planus has been reported as a complication of chronic hepatitis C virus infection and can be a sign of chronic graft-versus-host disease of the skin. It has been suggested that true lichen planus may respond to stress, where lesions may present on the mucosa or skin during times of stress in those with the disease. Lichen planus affects women more than men (at a ratio of 3:2), and occurs most often in middle-aged adults. Lichen planus in children is rare.
Allergic reactions to amalgam fillings may contribute to the oral lesions very similar to lichen planus, and a systematic review found that many of the lesions resolved after the fillings were replaced (PMID 15529127).
== Clinical features ==
The typical rash of lichen planus is well-described by the “5 P’s”: well-defined pruritic, planar, purple, polygonal papules. The commonly affected sites are near the wrist and the ankle. The rash tends to heal with prominent blue-black or brownish discoloration that persists for a long time. Besides the typical lesions, many morphological varieties of the rash may occur. The presence of cutaneous lesions is not constant and may wax and wane over time. Oral lesions tend to last far longer than cutaneous lichen planus lesions.
Oral lichen planus may present in one of three forms.
- The reticular form is the most common presentation and manifests as white lacy streaks on the mucosa (known as Wickham’s striae) or as smaller papules (small raised area). The lesions tend to be bilateral and are asymptomatic. The lacy streaks may also be seen on other parts of the mouth, including the gingiva (gums), the tongue, palate and lips.
- The bullous form presents as fluid-filled vesicles which project from the surface.
- The erosive form presents with erythematous (red) areas that are ulcerated and uncomfortable. The erosion of the thin epithelium may occur in multiple areas of the mouth, or in one area, such as the gums, where they resemble desquamative gingivitis. Wickham’s striae may also be seen near these ulcerated areas. This form may undergo malignant transformation.
The microscopic appearance of lichen planus is pathognomonic for the condition
- Hyperparakeratosis with thickening of the granular cell layer
- Development of a “saw-tooth” appearance of the rete pegs
- Degeneration of the basal cell layer
- Infiltration of inflammatory cells into the subepithelial layer of connective tissue
Lichen planus may also affect the genital mucosa – vulvovaginal-gingival lichen planus. It can resemble other skin conditions such as atopic dermatitis and psoriasis.
Rarely, lichen planus shows esophageal involvement, where it can present with erosive esophagitis and stricturing. It has also been hypothesized that it is a precursor to squamous cell carcinoma of the esophagus.
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.
The clinical presentation of lichen planus may also resemble other conditions, including:
- Lichenoid drug reaction
- Discoid Lupus Erythematosus
- Chronic Ulcerative Stomatitis
- Pemphigus Vulgaris
- Benign Mucous Membrane Pemphigoid
- Oral leukoplakia
- Frictional keratosis
A biopsy is useful in identifying histological features that help differentiate lichen planus from these conditions.
Treatment of Lichen planus
Currently there is no cure for lichen planus but there are certain types of medicines used to reduce the effects of the inflammation. Lichen planus may go into a dormant state after treatment. There are also reports that lichen planus can flare up years after it is considered cured.
Medicines used to treat lichen planus include:
- Oral and topical steroids.
- Oral retinoids
- immunosuppressant medications
Aloe vera []
Lichen Planopilaris is the specific name given to lichen planus on the scalp that may cause permanent, scarring alopecia. If left untreated the scarring will cause permanent hair loss. The Cicatricial Alopecia Research Foundation is a non-profit organization that provides support and resources for people with lichen planopilaris.
Homeopathy Treatment for Lichen planus
Keywords: homeopathy, homeopathic, treatment, cure, remedy, remedies, medicine
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’. The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition. The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines.
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit the Materia Medica section at Hpathy.
None of these medicines should be taken without professional advice and guidance.
Homeopathy Remedies for Lichen planus :
Agar., anac., ant-c., apis., ars., ars-i., chin-a., iod., jug-c., kali-bi., kali-i., led., merc., sars., staph., sul-i.,
Dr. Manish Bhatia
BHMS, BCA, M.Sc. Homeopathy (UCLAN, UK), CICH (IACH, Greece)
Dr. Manish Bhatia is the Founder Director of Hpathy.com, world’s leading homeopathy portal, serving homeopathy to more than half a million people every month. He is also Editor of Homeopathy for Everyone.
He runs a consultation office at Jaipur (Asha Homeopathy) and is one of the most well known Indian homeopaths globally. He has been practicing since 2001 and is helping Autism and other psychiatric patients since 2006. He was awarded Rajasthan’s foremost Raja Pajvan Dev Award For Excellence in the field of Medicine in 2015.
He has been working as an Asso. Professor of Organon of Medicine at S. K. Homeopathic Medical College since 2002. He was awarded with the prestigious APJ Abdul Kalam State Level Teacher’s Award in 2016. He has also given seminars and webinars in several countries of Europe, Americas and Australia.
He is the author of Lectures on Organon of Medicine Vol. I & II (English, Bulgarian, German editions), which are approved by the Central Council of Homeopathy (India) for BHMS and MD (Hom) syllabus. He is a contributing author to the book “Homeopathy and Mental Health Care: Integrative Practice, Principles and Research” and co-editor of “The Fireside Book of Homeopathy Tales.”