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.)