Lichen planus (chronic skin inflammation)

Description A chronic condition...

Description

A chronic condition that may cause inflammation of the skin of the legs, trunk, arms, wrists, scalp, penis, lining of the mouth, vagina, toe-nails and fingernails. The rash comes and goes and is itchy, mildly swollen and red or purplish. It is most common in adults over 40, but can affect people of any age. The cause of this disorder is not known but in some cases it seems to be triggered by viral hepatitis (liver inflammation) or allergic reactions.

Symptoms

The skin lesions are itchy and can be anywhere on the body but are most commonly located on the inner areas of the wrist, legs, torso, or genitals. They can be single or in clusters and have distinct borders. They are reddish-purple in the skin and gray-white in the mouth with a "lacy" appearance. Other symptoms include ridges in the nails, and hair loss.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. A skin biopsy or biopsy of a mouth lesion can confirm the diagnosis. Additional blood tests may be performed to rule out hepatitis or to identify an allergic reaction that could trigger lichen planus.

Tests:
Comprehensive metabolic panel (CMP)

Other Specific Tests: Skin lesion biopsy

Specialists:
Dermatology, Pediatric Dermatology, Telemedicine Dermatology

Treatment

Treatment depends on the severity of symptoms. No treatment may be needed for mild cases. Other options include: topical steroids (triamcinolone acetonide), oral steroids (prednisone), injected steroids, topical or oral retinoic acid (a synthetic form of vitamin A), calcineurin inhibitors such as tacrolimus (Protopic ointment) or pimecrolimus (Elidel cream) and ultraviolet light therapy. Anti-histamine medications may help with the itching. Avoiding or treating potential triggers may hasten recovery and avoid recurrence.