Lichen planus is a condition that mainly affects the skin to cause an itchy rash. About 1 in 100 people develop lichen planus. More than two thirds of cases occur in people aged 30-60 years. Both sexes are affected equally.
In present study, it is observed that prevalence rate of oral lichen planus was 1.5 percent. 57 percent of patients were associated with stressful lifestyle. Reticular lichen planus was the most common clinical sub type found. Lichen planus is a pruritic inflammatory dermatosis that is commonly associated with mucosal involvement and rarely with nail dystrophy and scarring alopecia.
The cause is unknown but a T-cell driven immune mechanism is postulated, as an almost identical rash can be caused by certain drugs (e.g. gold, levamisole, penicillamine or antimalarials) or by graft-versus-host disease.
4 Main Types of Lichen Planus
a) Reticular: Features a white web-like pattern that is easy to discern in lichen planus pictures. This pattern is called “Wickham’s Striae.”
b) Erosive: A bright red rash that typically affects mucous membranes including the mouth and genitals. In more severe cases, ulceration can occur.
c) Bulbous: Fluid-filled blisters and lesions that can occur in the mouth, genitals, lower limbs and trunk.
d) Atrophic: The rarest form typically affects the trunk and legs, or other areas that have experienced one of the other lichen planus types. The rash features whitish blue papules with a center that has atrophied or broken down.
Clinical features
The rash is characterized by small, purple flat-topped, polygonal papules that are intensely pruritic. It is common on the flexors of the wrists and the lower legs but can occur anywhere. There may be a fine lacy white pattern on the surface of lesions (Wickham's striae). Lesions may fuse into plaques, especially on the lower legs and in black Africans. Hyper pigmentation is common after resolution of lesions, especially in patients with pigmented skin. Atrophic, hypertrophic and annular variants can occur. Lichen planus lesions often localize to scratch marks. If lesions occur in the scalp they may cause a scarring alopecia.
Mucosal involvement is common. The mouth is the most commonly affected but the oesophagus and the anogenital region can be involved. It can present as lacy white streaks, white plaques or as ulceration. The prominent mucosal symptom is of severe pain rather than itch. Nails may be dystrophic and can be lost altogether (with scarring and 'wing' formation) in severe disease.
Prognosis
The condition often clears by 18 months but can recur at intervals. The hypertrophic and atrophic variants and mucosal disease are more persistent, lasting years. Ulcerative mucosal disease is premalignant.
Treatment
Homeopathy involves detail case taking of patient with considering the patient as a whole. Treating the man is disease is the main aim in homoeopathy. It works on the immune system stimulating the fighter cells in the body to promote healing and bring about cure. remedies like sulphur, syphilinum, borax are very useful in treating such cases.
Regimen
1. Eat folate
2. Consume turmeric
3. Eat foods rich in Vitamin A
4. Take Epsom salt baths
5. Apply tea tree essential oils and coconut oil
6. Stress management
7. Routine exposure to early morning sun
(Caution: Do not self- medicate take homoeopathic medicines under physician supervision.)