Lichen Planus is a chronic inflammatory condition that can affect the skin, mucous membranes, nails, or hair. When it involves the mouth, it is referred to as oral lichen planus. This condition can cause discomfort, pain, and potential complications if left untreated.
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Causes
The exact cause of lichen planus is unknown, but it is believed to involve an autoimmune response where the immune system attacks cells of the skin or mucous membranes. Possible contributing factors include:
1. Autoimmune Reactions - The immune system mistakenly targets healthy tissue.
2. Genetic Predisposition - Family history may play a role.
3. Triggers:
Medications: Certain drugs like NSAIDs, antihypertensives, or antimalarials.
Dental Restorations: Allergies to amalgam fillings.
Infections: Hepatitis C virus has been linked to lichen planus.
Stress: Emotional or physical stress may exacerbate symptoms.
4. Hormonal Changes - May play a role, especially in women.
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Signs and Symptoms
Oral Lichen Planus:
White, Lacy Patches - Reticular (web-like) white lines on the inner cheeks, gums, or tongue.
Red, Painful Lesions - Erosive forms cause redness, swelling, and sometimes ulceration.
Burning Sensation - Particularly with spicy, acidic, or hot foods.
Dry Mouth - Accompanied by discomfort.
Mild Bleeding - In severe cases, brushing may cause the gums to bleed.
Cutaneous (Skin) Lichen Planus:
Purple, Flat-Topped Bumps - Itchy lesions, often on wrists, legs, or ankles.
Fine White Lines (Wickham's Striae) - On the surface of skin lesions.
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Effects
1. Pain and Discomfort - Oral lesions can interfere with eating, drinking, and speaking.
2. Risk of Secondary Infections - Erosive lichen planus may lead to bacterial or fungal infections, like oral thrush.
3. Increased Cancer Risk - A small percentage of cases may develop into oral squamous cell carcinoma (in long-standing, untreated cases).
4. Emotional Stress - Chronic discomfort and appearance of lesions can lead to anxiety or depression.
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Solutions and Management
Medical Treatments:
1. Topical Corticosteroids
Creams, gels, or mouthwashes to reduce inflammation and discomfort. Examples include clobetasol or triamcinolone.
2. Systemic Corticosteroids
For severe cases, oral steroids may be prescribed.
3. Immune-Modulating Agents
Medications like tacrolimus or cyclosporine may be used for resistant cases.
4. Antifungal Medications
If secondary fungal infections develop, antifungal treatments like nystatin or fluconazole may be necessary.
5. Pain Relief
Over-the-counter pain relievers or medicated mouthwashes containing anesthetics can help reduce pain.
Lifestyle and Home Remedies:
1. Maintain Oral Hygiene
Use a soft-bristled toothbrush and non-irritating toothpaste to avoid aggravating lesions.
2. Avoid Triggering Foods
Limit spicy, acidic, or rough foods that can irritate oral lesions.
3. Quit Smoking and Alcohol
These can exacerbate symptoms and increase the risk of complications.
4. Stress Management
Practice relaxation techniques like yoga or meditation to minimize stress-related flare-ups.
Regular Monitoring:
Schedule regular dental and medical checkups to monitor lesions and rule out malignant changes.
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When to See a Doctor
If you notice persistent white patches, redness, or pain in your mouth or on your skin.
If symptoms worsen or interfere with daily activities like eating or speaking.
If lesions fail to respond to initial treatments or recur frequently.
Prompt diagnosis and management can reduce discomfort, prevent complications, and improve the quality of life.
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