If you’ve been suffering from purple-looking rashes accompanied by very bad itching, please visit a dermatologist. You could be suffering from what is called Lichen planus.
Lichen planus is a condition where a person develops rash like lesions on their body due a reaction within the body’s immune system. According to Dr Shefali Trasi Nerurkar, dermatologist, ‘Lichen Planus is a chronic inflammatory disease of the skin that affects one’s skin mucous membranes and hair. Since the lesion resembles lichen, the condition is termed as lichen planus’.
Dr Shefali says, ‘Lichen planus is an autoimmune disease with an unknown initial trigger. Since the reason for the onset of this condition is unknown, anybody can suffer from it.'
But there are some people who are in higher risk groups. For instance patients on certain drugs like beta blockers, anti-malarial drugs, metformin and Penicillamine have risk of triggering lichen planus. Apart from that the condition is largely seen in children and females suffer more from it as compared to males.
According to the American Academy of Dermatology, lichen planus is a fairly common condition whose symptoms are commonly seen around the wrists and on the inside of one’s mouth. Dr Shefali says, ‘The most common symptom of lichen planus is experiencing severe itching or pruritus. The subsequent lesions formed are purple to violaceous in colour and flat in appearance.’
‘There can be multiple types of lichen planus depending on the area affected. In the oral or genital area it forms ulcers or erosions which can be quite painful. On the scalp, there is cicatricial alopecia (hair loss in patches) with permanent hair loss. Most patients will notice a cracking and thickening of skin on the palm and soles as well. In the case of stable lesions (long term, non spreading lesions) of lichen planus, one will usually have very deep residual pigmentation which takes many years to improve.’ She adds.
It is fairly to distinguish between a rash due to lichen planus and one that’s not due to the condition. One distinguishable characteristic is the colour of the rashes. Dr Shefali says, ‘Lichen planus is classically purple in colour and is accompanied with intense itching. Moreover lichen planus commonly affects areas like the wrists, inner part of the fore arms, legs, chest and back.’
In most cases the diagnosis of the condition is fairly simple and is based on the symptoms that the patient has. According to Dr Shefali, ‘Diagnosis is mostly clinical in classic cases but if a doctor is not sure then a skin biopsy helps give a confirmation through a microscopic examination of the skin sample.’
‘There is no cure for lichen planus, but many treatment options are available to give symptomatic relief and improve the cosmetic concerns of a patient. Medical treatments include the use of retinoids such as acitretin, oral steroids, dapsone, HCQs (hydroxychloroquine) and cyclosporine. Apart from that a doctor might also prescribe topically applied moderately potent steroids, tacrolimus, pimccrolimus, and skin lightening creams to improve active and pigmented lesions.’ Says Dr Shefali.
There are no serious side effects or complication of any of the forms of treatments used for patients with lichen planus. But one should definitely make sure they visit their doctor regularly to keep a check on the progress of the condition.
Since the reason for this condition is still unknown, there is no known way to prevent the condition. But according to Dr Shefali, ‘Although there is no known way to prevent the onset of the condition, avoiding certain drugs and dental amalgams can prevent recurrence. Moreover acute infections should be treated promptly and the patient should learn to relax and lower their stress levels – since it can also trigger a reaction.’
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Dr Shefali Trasi Nerurkar