What is it about ?
Lichen planus is a rare skin disease. It is believed to be an autoimmune disease, a condition caused by a disruption in the immune system. Inflammatory cells, which normally fight bacteria and viruses, for example, affect the skin’s own cells. But the precise cause of the disease is not yet well known.
Usually the disease develops in middle-aged men or women. Small shiny, flat, red-purple bumps (papules), often accompanied by itching, then appear on the body, usually on the inner side of the wrists, lower back and ankles, with whitish lines visible at their sides. area. Papules are usually arranged in groups, lines, or rings. On the legs, the lesions are usually thicker. If the skin is damaged (eg after scratching), new lesions may appear in these areas. Lichen planus on the scalp can cause patchy hair loss, leaving scars, but it rarely happens.
In 30 to 70% of people with lichen planus, there are also mucosal abnormalities, especially on the cheek and tongue, where a network of white lines can be observed. Small sores or painful ulcers can develop in these places. Allergy to dental amalgam or gold fillings can lead to mucosal damage. Nail abnormalities (especially ridged and fragile nails) occur in 10% of cases.
What is its frequency?
Lichen planus probably affects around 1% of the population. One in five people have only a limited number of papules and usually have no symptoms. However, the majority suffer from itching (sometimes very severe). More than half develop new lesions, often after a few years.
How to recognize it?
You notice flattened red-purple papules, usually with itching, most commonly on the inner side of the wrists, lower back, or ankles. In the mucous membranes, you can see a network of white lines, sometimes with small sores or small painful ulcers.
How is the diagnosis made?
The skin lesions described are typical of lichen planus. The diagnosis can be confirmed by a skin biopsy (taking a piece of skin).
What can you do ?
Try not to scratch yourself, as the injured areas may be the site of new lesions.
Practice good oral hygiene and avoid aggravating factors (tartar, sharp edge of a dental prosthesis, poorly adapted prostheses).
If significant mucosal damage persists over the long term, avoid smoking and alcohol consumption as these are factors that slightly increase the risk of oral cancer.
What can your doctor do?
The lesions usually heal spontaneously within two years. It seems that lichen planus can occur as a reaction to certain medications. If such a reaction is suspected, it may be prudent to temporarily stop treatment in consultation with your doctor.
Strong-acting corticosteroid ointments usually have a beneficial effect after a few weeks. In severe cases, it is good to see a dermatologist. He will determine whether it is indicated to initiate treatment in the form of tablets or light therapy (UVB, PUVA). After treatment, the lesions often leave a brown mark. This pigmentation disappears spontaneously after a few months.
Lichen in the mucous membranes is often more difficult to treat. In some cases, lesions do not heal until after removal of amalgam or gold dental fillings.
Want to know more?
- Lichen planus – Mouth (images) – DermIS – Dermatology Information System
- Lichen planus – Nails (image) – DermIS – Dermatology Information System
- Lichen planus – Skin (image) – DermIS – Dermatology Information System
- Tips for unparalleled oral hygiene – Christian Mutuality
- Stop smoking. It’s possible – Tabacstop
- Alcohol, the point on your consumption – Stop or else?
- Corticosteroids for the skin – CBIP – Belgian Pharmacotherapeutic Information Center
- Corticosteroids – CBIP – Belgian Center for Pharmacotherapeutic Information
- UVB therapy, here, Where to find on this page of Cliniques St Luc UCL
- PUVAtherapy, here, Where to find on this page of Cliniques St Luc UCL
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- Alcohol aid – Le Pélican & Le center ALFA
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