subject: Lichen planus diagnosis and treatment [print this page] Lichen planus diagnosis and treatment
Lichen planus is a papulosquamous disorder of debatable etiology, characterized by the formation of flat topped, polygonal, greyish white, purple/ iliac eruptions. Middle age people of both sexes are its victims. Its precise etiology is unknown. However, it may either be bacterial or viral in origin. Immunologic factors are also incriminated due to the presence of consistent immunofluorescence pattern. It may also follow bone marrow transplantation or graft versus host reaction. Furthermore, certain individuals are genetically predisposed to it. Also several drugs such as chloroquine, quinacrine, streptomycin, para-amino salicylic acid (PAS), methyl dopa, quinidine, phenothiazine, chlorpropamide, gold, bismuth, levamisole, and penicillamine are incriminated. Exposure to paraphenyl lenediamine salts encountered in color photographic developer may also produce these lesions.
Diagnosis The diagnosis of lichen planus is clinical; However, it may be supplemented by histopathology. Hematoxylin eosin stained section reveals the presence of( 1) Hyperkeratosis, (2) Focal hypergranulosis, (3) Irregular acanthosis resulting in saw tooth appearance of rete ridges, (4) Liquefaction degeneration of basal cell layer, (5) A band like upperdermal lymphocytic infiltrate, (6) Incontinence of the melanin, (7) Colloid bodies may be present in the deep dermis, (8) Small separation between dermis and epidermis may be present ( Max-joseph spaces)
Treatment Lichen planus tends to resolve spontaneously after varying period of time. In mild cases, treatment is symptomatc. Antihistamines may be administered to relieve pruritus. Topical cortico-steroids may be applied for their antipruritic and anti-inl ammmatory effects. Severe, acute, wide spread lichen planus may benefit from a tapered course of corticosteroid. Griseofulvin may also be beneficial. Oral lichen planus respond to topical application of corticosteroid in oral protective base. Hypertrophic lichen planus may benefit from intralesional cortico-sterois or potent corticosteroids applied under occlusion.
Unani traetment Applied vinegar at the affected area thrice in a day for 5 days.
Applied garlic juice at the affected area and majoon piyaz 6 gm two times daily for 1 month.
Caring for your skin during a lichen planus outbreak can be done easily at home with natural remedies. Using colloidal oatmeal while soaking in a warm bath several times a day may help alleviate the itch associated with skin lichen planus. Applying a cold compress to the affected skin area can cool the rash and cut down on the itch.
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