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Lichen Planus: Exploring Theories, Causes, Management, and Treatment

Nov 4, 2023
Dr Amit Goyal

How common is Lichen planus?

Lichen Planus is believed to affect around 1-2% of the global population, displaying no racial predilection. However, it is most commonly diagnosed in individuals between the ages of 30 and 60. Although both men and women can develop Lichen Planus, it tends to be more prevalent in females.

Theories Behind the Causes of Lichen Planus

While the exact cause of Lichen Planus remains a mystery, several theories attempt to explain its origins:

  1. Autoimmune Theory: The most widely accepted theory suggests that Lichen Planus is an autoimmune disorder. This means the body's immune system mistakenly attacks its own skin and mucous membrane cells. This theory is supported by the finding of T lymphocytes in Lichen Planus lesions, indicating an immune-mediated process.

  2. Genetic Factors: Some studies suggest a genetic predisposition to Lichen Planus, with a higher incidence observed in certain families. However, specific genetic markers have yet to be identified.

  3. Viral Infections: The link between Hepatitis C and Lichen Planus supports the theory that viral infections could trigger the condition. Researchers continue to investigate the role of other viral infections as potential triggers.

  4. Neurogenic Factors: Stress and psychological factors are considered to potentially exacerbate or trigger Lichen Planus. Some research points towards a neurogenic inflammation process, where nerve endings in the skin might play a role in the development of the condition.

  5. Drug-Induced Lichen Planus: Certain medications, including antimalarials, antihypertensives, and some antibiotics, have been known to induce Lichen Planus-like eruptions. This suggests a possible drug-reaction mechanism.How is Lichen planus treated?

Patient Stories

For many, the journey with Lichen Planus starts with confusion and misdiagnosis. Take Sarah, for instance, a 35-year-old teacher from Manchester, who noticed purplish, flat-topped bumps on her wrists. They were itchy and appeared without any clear reason. After several months of over-the-counter treatments and misdiagnosis, she was finally diagnosed with Lichen Planus by a dermatologist. Like Sarah, numerous patients recount the relief in having a name for their condition, which is the first step in their treatment journey.

Management of Lichen Planus

Effective management involves both lifestyle modifications and medical interventions:

  • Stress Management: Given the potential link between stress and flare-ups, stress-reducing activities can be beneficial.

  • Avoiding Triggering Medications: Patients should inform their healthcare providers of their condition to avoid prescriptions that might exacerbate Lichen Planus.

Treatment Strategies

While no cure exists, treatments aim to reduce symptoms and speed up healing:

  1. Topical Treatments: Corticosteroids remain the mainstay for reducing inflammation and itchiness.

  2. Systemic Treatments: In severe cases, oral corticosteroids or immunosuppressants may be necessary.

  3. Phototherapy: This approach uses UV light to reduce symptoms, particularly for extensive skin involvement.

  4. Lifestyle Modifications: Adequate skin care and avoiding potential irritants can help manage symptoms.

Conclusion

Lichen Planus is a multifaceted condition that requires a comprehensive approach in both understanding and treatment. Theories regarding its causes continue to evolve, offering hope for more targeted and effective treatments in the future. Patients should engage in open discussions with their dermatologists to manage this condition effectively, acknowledging that while Lichen Planus can be persistent, it is manageable with the right strategies.

Patient resources for Lichen planus

Living with Lichen Planus can be challenging, but several resources in the UK provide support and information:

 - The British Association of Dermatologists (BAD) - [www.bad.org.uk](https://www.bad.org.uk)

- The British Skin Foundation - [www.britishskinfoundation.org.uk](https://www.britishskinfoundation.org.uk)

- NHS UK - [www.nhs.uk](https://www.nhs.uk)

- Lichen Planus UK Support Group - Offers a community for those affected, sharing experiences and advice.

 Each of these resources provides valuable information for both newly diagnosed individuals and those who have been managing the condition for years.

 In conclusion, Lichen Planus is a complex condition that requires a nuanced approach to treatment and support. Through a combination of medical intervention and supportive resources, individuals living with Lichen Planus can manage their symptoms and maintain a good quality of life. It is always recommended to consult with a healthcare professional or dermatologist, like those at mySkinDoc, for diagnosis and personalized treatment options.

If you feel that you may have this condition or you want to get to the bottom of what is happening to your skin, have a consultation with mySkinDoc and we will help you with your skin.

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