Lichen Planus

Complications of lichen planus

Some hypotheses have been formulated regarding the dangers that could derive from the dermatosis of lichen planus: some affected patients could be at risk of tumors of the skin, penis, oral mucosa and vulvovaginitis. In this regard it is advisable to seek medical attention from the earliest cutaneous manifestations, to ascertain that the disease does not degenerate into carcinoma.

Diagnosis

As we have already analyzed, the reticular lesions of lichen planus are almost unmistakable, therefore the diagnosis is quite simple. Unfortunately, for the other forms of lichen, recognition does not appear so easy, therefore, when the patient is not subjected to a correct diagnostic investigation, there is the risk of confusing lichen for more simplistic diseases.

In general, the doctor hypothesizes a first diagnosis based on the symptoms complained of by the patient, then proceeds with a dermatological examination and possibly with laboratory tests, such as allergy examination, hepatitis C test and incisional biopsy, thus researching the possible etiological elements responsible for lichen planus.

therapies

To learn more: Drugs to treat Lichen Planus

Lichen planus is a subtle and equivocal disease, in which the therapy is almost problematic: in some subjects the dermatosis could last for long periods, in others it could even heal spontaneously. It is necessary to pay more attention to the lichen planus of the scalp, genitals, mucous membranes and nails, guilty of being the most harmful in terms of symptoms: in fact, the lichen planus that affects these areas tends to last a long time, besides generating significant and annoying inconveniences.

Inflammation is generally treated with topical corticosteroids (applied directly in situ), administered orally or injected intravenously. From a therapeutic point of view, cortisone derivatives are extraordinary because they are very effective, but on the other hand, they are easily responsible for complications such as, for example, irreversible epithelial atrophy and oral candidiasis. Furthermore, the excessive use of oral and intravenous cortisone can cause diabetes mellitus, osteoporosis and hypercholesterolemia.

In addition to these drugs, according to the type of lichen planus and the symptoms, the doctor can also prescribe retinoids (whose use must be banned during pregnancy, because teratogens), antihistamines and phototherapy (UVB).

Sometimes, drugs with an immunosuppressive action are prescribed, such as cyclosporine, particularly effective in the case of erosive lichen; even this pharmaceutical specialty is not without side effects, as it could generate toxicity in the kidneys.

Unfortunately, most patients are destined not to heal at all and are forced to live with lichen planus throughout their lives, since the etiological factor that is really (and not only ideally) responsible for dermatosis is still unclear: once diagnosed, the patient must scrupulously follow the therapeutic treatment for life.

Summary

Lichen planus in brief:

Disease	Lichen planus
Description	Chronic inflammatory dermatosis deriving from immunology, which mainly involves the skin, mucous membranes and nails
Imprint of recognition of the disease	Pruritic and Purple Polygonal Papules (4P disease)
Course	Relapsing, benign in nature
Etymology of the term	The term derives from the typical manifestations of the disease, very similar to the arborescent formations of lichens
Incidence of lichen planus	Lichen planus: rarely affects children liche oral planus occurs between 0.1 and 2.2% of cases it mainly affects women aged between 50 and 70 years infantile lichen planus is a rare variant of the Indian breed the incidence rate is estimated at around 0.02% and 2%
Etiology of lichen planus	Uncertain; the possible triggers are: genetic predisposition environmental, biological, chemical and pharmacological factors alteration of white blood cell membrane antigens and T lymphocytes hepatitis B vaccine, anti-flu, NSAID abuse, antihypertensives, anti-arthritis, herpes simplex and hepatitis C smoking, dental amalgam, emotional stress and fungal infections
Histopathology	Alteration of the cellular composition of the injured anatomical sites: excess of fibrinogen at the level of the basement membrane, visibly thickened atrophic epithelial cells apoptosis of keratinocytes infiltration of T lymphocytes in mucous membranes
Classification	Anal-genital Lichen planus (the sclero-atrophic lichen is the most severe form) Nail lichen planus (of the matrix or of the nail bed) Lichen planus cutaneo (remember: lichen planus palmo-plantar and hypertrophic lichen planus) oral lichen planus: atrophic lichen reticular lichen erosive lichen (ulcerative or atrophic) plaque lichen planus Lichen planus of the scalp
Complications of lichen planus	Risk of tumors of the skin, penis, oral mucosa and vulvovaginitis
Lichen planus diagnosis	first diagnosis according to the symptoms reported by the patient dermatological examination and possibly laboratory tests (allergy test, hepatitis C test and incisional biopsy)
Therapies against lichen planus	topical corticosteroids for oral use or intravenously injected (very effective but responsible for serious complications, when used for long periods) retinoids antihistamines and phototherapy (UVB) drugs with immunosuppressive action The patient suffering from lichen planus must strictly follow the therapeutic treatment for life.