Lichen Planus

Lichen Planus

Lichen Planus, an obstinate skin disorder has baffled not only the patients but also the practitioners equally. The cases of Lichen Planus have been observed all over the world, irrespective of the race, skin color and culture. The medical field today finds little help for this chronic disease. Fortunately, homeopathy, the fast growing alternative medicine has a definite, promising treatment for Lichen Planus.
It is a long standing (chronic), recurring, non-allergic, non-infectious, non-contagious disease of the skin, of which the exact cause is not yet fully understood.
It can affect skin, oral mucosa, tongue, scalp, genitals and nails. However, it is less likely that it affects all the areas as stated, at the same time. It has a tendency to relapse after some months or years. Females are more frequently affected as compared to the male counterpart, however, uncommon to find it in children. Over 1.9% of the total population is affected by Lichen Planus.

Signs and symptoms:

The typical appearance of the Lichen Planus eruption is round or irregular shape, raised slightly above the skin level, brown or pinkish or black in color.

Commonly Affected Parts in Lichen Planus

Lichen Planus largely affects skin. It may also affect mouth (gums, tongue, palate) (oral Lichen Planus), the scalp, nails, or the genitals (glans, penis). It could affect one or more of the said body parts. It is not a rule that every patient with Lichen Planus will have all the said areas affected. In males it could affect the glans of penis and in females the vulva or vagina. It can
be said that more areas affected, more difficult to treat. Also, experience says that the oral or genital Lichen Planus is more difficult to treat as compared to that on the skin. Also, Lichen planus affecting the scalp when leads to scarring, may lead to permanent hair loss; which is difficult to treat.

Lichen Planus and Hepatitis:

Some of the latest studies have shown a co-association of Lichen Planus with a rare variety of Hepatitis-C. It may be noted that the exact connection and causative link has not been established between the two entities. It may be noted that patients with Hepatitis C have some proneness to develop Lichen Planus; the reverse is not true.

Causes of Lichen Planus

Lichen Planus is found to be an immunologically mediated disease. The exact cause of Lichen Planus is not very clearly understood. Some triggers have been found which are clinically found to be responsible for Lichen Planus. It is one of those conditions where the exact cause remains unknown till the date. There are theories. In some cases there are obvious links with the facts such as

1. Modern Medicines

Certain modern medicines such as non-steroidal anti-inflammatory pain killers (NSAID), antihypertensive medicines, amalgamated dental filling, etc are known to induce Lichen Planus, which has a tendency to persist despite the discontinuation of the said medicines.
It may be of interest to list the common modern medicines which are know to induce Lichen Planus:
NSAIDs (Non-steroidal anti-inflammatory drugs)TetracyclineCaptoprilPropranololSulfonamideDapsoneFurosemideChloroquinePenicillamineMethyldopaEnalaprilAllopurinol (anti-gout medicine)

2. Chemical Contact

Contact with certain chemicals (paraphenylenediamine), drugs (Arsenic compounds, certain metals such as Gold, Bismuth, Quinacrine), exposure to light by photography development) etc.

3. Stress Leads to Lichen Planus

In our in-depth studies, we have observed that certain intense and prolonged emotional stress such as anxiety, shock, traumatic childhood, sadness; disappointment, failure, humiliation, etc. often initiate the process of Lichen Planus. Intense stress is likely to trigger some immunological processes which lead to development of Lichen Planus. The exact mechanism is not yet understood. Stress has been found to be an important trigger in many cases, but not all.

4. Genetic Causes

Hereditary tendency. We have observed Lichen Planus running in family. However, it is not a rule that if you have Lichen Planus, your children will necessarily have it. Also, it is not a rule that every patient having Lichen Planus must have their parents or relatives the same disease. It is observed that there is some autoimmune disease such as Lichen Planus, eczema, cancer, psoriasis, etc. in the family, suggestive of genetic link.

Lichen Planus Symptoms

1.Lichen Planus symptoms may appear on skin, nails, mouth, scalp or genitals in one or more of the following ways.
2.Round, irregular, thickened, flat-topped, dark skin lesions
3.Pink, gray, brown or reddish eruptions, raised above skin level, with roughness and mild scaling in some cases.
4.Slow, gradual onset
5.Rough, oily look of lesions
6.Intense itching or no itching
7.New lesions of Lichen planus come up in areas where skin is scratched or injured. This is called as Koebner’s phenomenon
8.Bleeding may be present on scratching
9.Oral Lichen planus presents as white streaks on the mucosa of mouth, tongue and gums. There may be ulcers in the oral mucosa, any part of mouth. The ulceration can be mild or extensive.
10.Genital Lichen planus shows white streaks or ulcers on vulva, vagina, prepuce or shaft of penis. (Photo of male genital will open in new window.) Genital Lichen planus in both sexes can be painful.
11.Lichen Planus of nails may present with ridged, deformed nails
12.Burning in mouth while eating spicy food

Oral Lichen Planus: Causes, Symptoms & Treatment

Oral Lichen Planus is a chronic inflammatory, non-infectious disease that causes lesions on the buccal mucosa, tongue and/or gums. It affects approximately 1-2% of the general adult population. Although oral Lichen Planus predominantly occurs in adults older than 40 years, younger adults and children can also be affected. Lichen Planus may affect either skin or mouth or genitals or the nails; or in any combination of two or more. In a large study, we have not come across many cases of children having oral Lichen Planus.look at the throat with a torch to find inflamed, red, congested tonsils. There may be visible septic foci (small pus pockets). Externally, one may palpate enlarged and mildly painful neck glands, indicating some more lymph glands in the neighborhood.

Causes of Oral Lichen Planus

Oral Lichen Planus may be caused by more than one cause. Some drugs often induce it. Stress is also a major trigger factor. Genetic factor is usually found in the back ground. Oral Lichen Planus is considered pre-cancerous. However, it is not so common for Oral Lichen Planus to turn cancerous. Click here to understand the causes in detail.

Some of the commonly known drugs inducing Lichen Planus are:

1.Non-steroidal anti-inflammatory drugs (NSAIDs)
2.Sulfonylureas
3.Antimalarials
4.Beta-blockers
5.Certain angiotensin-converting enzyme (ACE) inhibitors

Symptoms of Oral Lichen Planus

1.Generally, the onset of oral Lichen Planus is insidious and patients are unaware of its commencement. Usually the medical or dental practitioner identifies the clinical changes in the oral mucosa on routine examination.
2.Common symptoms include sensation of roughness in the lining of the mouth, sensitivity to hot or spicy foods, soreness of oral mucosa and gums, red or white patches on the oral mucosa and gums, or oral ulcerations.
3.The lesions of oral Lichen Planus are usually bilateral.
4.Oral Lichen Planus lesions may be associated with patchy brown melanin (pigment) deposits in the oral mucosa.

Treatment for Oral Lichen Planus:

We worked on Lichen Planus for over two decades, and have been able to treat most cases with success using homeopathy, which is individualized, effective and very safe.

Lichen Planus of Nails: Causes, Symptoms & Treatment

Lichen planus can affect nails in about 10 percent of the cases. Nail involvement in LP in isolation is uncommon and has always been associated with typical skin lesions. Rarely nail lichen planus may occur in the absence of skin, oral or genital lesions.
The majority of nails changes results from damage to the nail matrix, or nail root. Nail changes can occur with or without skin involvement. The nails when affected tend to become deformed. Commonly only two or three fingernails or toenails are involved. Occasionally all the nails could be affected.

Signs of Nail Lichen Planus:

Nail changes associated with Lichen Planus includes:
1.Longitudinal ridging and grooving,
2.Pitting,
3.Nail thinning,
4.Nail becomes fragile and nail loss,
5.Brown discoloration,
6.Depressions of the nail plate,
7.Inflammation of the proximal nail folds which becomes erythmatous.
8.The skin of the fingertips shows a honeycomb appearance due to multiple, small, punctuate and hyperkeratotic depressions.

Symptoms of Nail Lichen Planus:

1.There may be no symptoms at all
2.Itching
3.Stinging sensation
4.Burning and pain in the fingertips

Differential Diagnosis:

1.Punctuate keratoderma
2.Allergic contact dermatitis
3.Psoriasis and psoriatic arthritis
4.Onychomycosis or fungus of nails
5.Lichen nitidus,Twenty-nail dystrophy
6.Secondary syphilis

Diagnosis:

To confirm the diagnosis biopsy is required. Associated history of lichen planus on skin may help to make the diagnosis.

Treatment for Nail Lichen Planus:

Homeopathy medicines are beneficial in the cases of Lichen Planus in the nails. The cracks in the nails heal and the brittleness improves. The discoloration goes away and the nails improve and normalize. (In our experience the Lichen Planus of the skin improves first and the nails improve later.) One can expect excellent improvement with homeopathy. It must be noted that Lichen planus of nails is more difficult to treat than one on the skin.

Variants (types) of Lichen Planus

Lichen Planus Hypertrophicus:

It looks like a keloid or hypertrophied scar, often found on the ankles.

Lichen Planus Actinus:
Lichen Nitidus:

Observed along with regular eruptions of LP, more on the light-exposed body parts.

Lichen Sclerosus et Atrophics:

A rare condition affecting the vulva, male genitals. With tremendous itching, there is atrophy and scaring of the affected organ.

Lichen Planus Linearis:

More closely aggregated eruptions, extending along the entire limb, seen in children.

Lichen Planus Annularis:

Often affecting the genitals and scrotum.

Lichen Planus Follicularis (Lichen Planopilaris):

Observed in the hair bearing areas such as scalp, pubic region.

Lichen Planus Atrophicus:
Bullous Lichen Planus:

Bullous eruption and vesicles.

Lichen Planus Pigmentosa:

As the name suggests, there is a kind of hyper-pigmentation which is grayish in color. Seen more in females in the western countries.
Normal any part of the body may get affected. However, it has a tendency to involve the skin of the lower limbs, legs and the mucous membrane of the mouth. The flexors of the legs, inner thighs, front of the wrists, and skin on the lower back are affected in many cases.
It has an affinity for the genitals are involved. In males, the glans; while in females the vagina and vulva may be affected.
One of the uncommon areas of affliction with Lichen Planus is eyelids.
The nails when affected tend to become deformed. In short, Lichen Planus affecting the skin, mouth (Oral Lichen Planus) and vaginal LP are some of the most common variants. When the oral mucosa or the genitals are affected, this condition is often neglected, reported late or incorrectly diagnosed.

Diagnosis of Lichen Planus

Lichen Planus can be diagnosed clinically by experienced eyes. Lesions on the skin have typical look as described elsewhere on this pages, and their location such as legs, back, mouth, scalp, genitals, nails, or elsewhere (more or less in this order) is important for diagnosis. The typical skin lesions of Lichen Planus are grayish, slivery, pinkish eruptions about 1mm to 4 mm in size; oval or round or irregular in shape, scaly and itchy in nature.
Sometimes the Lichen Planus eruptions, especially in early states, may resemble to some other diseases like atopic dermatitis, psoriasis, candidiasis (in mouth), leukoplakia (mouth), apthous ulcers (mouth).
In case of doubt, or to confirm the diagnosis, a biopsy would help. Biopsy is more often indicated in cases of oral and scalp Lichen Planus. Also, Lichen Planus of nails alone could resemble psoriatic nails or fungus infection of nails. Clinically trained eyes can differentiate in most cases.
Lichen Planus on the scalp may show some scarring by the time patient approaches for treatment. At times, you need to do a biopsy to confirm the diagnosis for scalp Lichen Planus. There may be associated patches of hair loss called alopecia areata.

Skin, Mouth, Nails, Scalp, Genitals:

Lichen Planus largely affects skin. It may also affect mouth (oral Lichen Planus), the scalp, nails, or the genitals. It could of more of the said body parts. Is is not a rule that every patient with Lichen Planus will have all the said areas affected. In males it could affect the glans of penis and in females the vulva or vagina. It can be said that more areas affected, more difficult to treat. Also, experience says that the oral or genital Lichen Planus is more difficult to treat as compared to that on the skin.

Under the microscope:

It is of less importance to the patients to know how Lichen Planus tissues look when seen under the microscope.
Lichen planus skin under microscopeAt times, one also observes the Lichen Planus eruptions appearing along the line of a scratch mark, called as Koebner’s phenomenon. It has an affinity for the genitals are involved. In males, the glans ; while in females the vulva may be affected.
The nails when affected tend to become deformed. In short, Lichen Planus affecting the skin, mouth (Oral Lichen Planus) and vaginal LP are some of the most common variants. When the oral mucosa or the genitals are affected, this condition is often neglected, reported late or incorrectly diagnosed. Lichen Planus affecting the food pipe (esophagus) is not a commonly encountered condition. However, some cases have been reported at some institutes.
All variants of Lichen Planus respond very well to homeopathic treatment. It can be said with confidence that Lichen Planus is curable using homeopathy. Homeopathy offers excellent results in Lichen Planus of the skin, mouth and genitals; in this order.

Homeopathy Treatment for Lichen Planus

Though Lichen planus appears on skin, mouth, genitals, nails or scalp; its roots are found in the immune system, which is governed by some genetic factors. It means, the treatment for Lichen planus has to be aimed by correcting or improving the immune system. If this is done, the disease would be treated or cured for a long time. If the treatment is done superficially by applying cortisone or such immunosuppressive medicine, the disease will get elevated superficially only to re-surface as soon as the effect of the medicine would be over.
Homeopathy offers research proven and highly effective treatment for Lichen Planus which has been scientifically documented. Contrary to the conventional treatment, which is governed by the use of cortisone, homeopathic treatment is amazingly curative, safe and longer lasting. We have researched on Planus for over two decades.
The Homeopathy Treatment

The homeopathic treatment for Lichen Planus is based on the individual case study of the patient’s disease, its cause, its spread, the area affected, the genetic tendency, mindset, etc. The treatment plans thus designed is addressed towards correcting the immune system, in turn treating Lichen Planus from within.

The duration of treatment:

The total length of treatment varies form case to case, depending of the following factors:
1.Duration of Lichen Planus
2.Areas affected (Skin, mouth, genitals, nails, scalp)
3.Extent of spread (Only skin or only mouth or skin with mouth, combination of parts, etc.)
4.Previous medication (Extensive use of oral cortisone may delay the course of treatment)
5.General health and associated diseases
One may expect a definite change in about three to five months, depending on the extent. The total length of medication may be anything between six months to two years or longer.

Why homeopathy for Lichen Planus?

The major benefits of homeopathy could be summarized as under:
1.It offers excellent treatment which has a success rate of over 85%
2.It offers immuno-correction hence gives deep-level healing
3.It offers long-lasting cure instead of temporary.
4.It is absolutely harmless, safe and free from any toxic effect.

Is the treatment (and its duration) different if Lichen Planus affects skin, mouth, genitals?

Well, the scope of improvement and the time required for the treatment of Lichen Planus also depend on its location. Experience shows that LP on skin is relatively easy to treat, as compared to one in the mouth or genitals. If one has it on mouth, genitals and skin, it is all the more difficult to treat. Similarly, it would take longer it is multi-location. The medicines are relatively different for skin LP or one in the mouth, genitals, scalp or nails.

Other Treatment Options for Lichen Planus

1.Corticosteroid creams
2.Corticosteroid tablets
3.Immune suppresive medicines
4.Photo Therapy
5.Antihistamines
6.Lichen Planus Curability Test
7.More about Homeopathy

Lichen Planus Pigmentosus Homeopathic & Conventional Treatment

Lichen Planus Pigmentosa is an uncommon skin disorders resembling Lichen Planus. This presents with oval grayish (turning blackish) brown marks on the face and neck or trunk and limbs without an inflammatory phase.
The skin in the affected area becomes dry, dark and hyper-pigmented and the area spreads at a slow pace. it may present in the form of sporadic spots, or on bilateral symmetrical locations, few scattered spots or big patches. In some patients the patches are small or large at times. The patches may remain steady or spread.
There is generally no itching or minimal itching. There are no eruptions or elevated lesions, as compared to Lichen Planus.
This has a genetic predisposition in estimated 30% cases. It is seen equally in males and females, more common in the young adults and the elderly.
It does not cause any major discomfort, the chief concern being cosmetic. The most common sites affected are face, arms, neck.
A trained physician can diagnose it on examination, biopsy is confirmatory.

The classical findings are:

01 Eruption of brownish-black, discrete, non-confluent, asymptomatic macules involving the neck, trunk and proximal extremities
02 Absence of any preceding inflammatory lesions
03 No previous drug exposure.

Conventional treatment:

Use of local cortisone is the most common mode for the treatment of LPP.

Homeopathic Treatment:

The condition takes a long duration to evolve and slow to respond to treatment. Long term homeopathic treatment gives good results, to control the further spread, to stop the disease activity and to reverse the hyperpigmentation to an extent. Complete recovery from hyperpigmentation may not be possible in most cases.

Lichen Sclerosus: Causes, Symptoms & Treatment

What is Lichen Sclerosus

Lichen Sclerosus is also known as Lichen Sclerosis (or Lichen Sclerosus et atrophicus). It is a painful skin condition that typically affects the vulva (or penis) and anus. It results in white patches on the skin, which causes scarring on and around genital skin.

Causes of Lichen Sclerosis:

In most of the cases the cause remains unknown. It is found to be an immunologically mediated disease. There are several factors found responsible for development of lichen sclerosis, such as auto-immune diseases, infections and genetic component. It may be associated with thyroid disease in some patients.

Incidence:

Women are more commonly affected than men (10:1) particularly in young girls (prepubertal) and postmenopausal women. Children are rarely affected.

Areas affected:

1.In females the vulva and anus
2.In males foreskin of penis
3.Non genital areas involve hair follicles or sweat glands on the surface of skin, breasts and under arms.

Signs and symptoms of Lichen Sclerosus:

If the disease is a mild case, there may be no symptoms.
In the early stage small white spots appear on the skin, which is shiny, and smooth in appearance later on the spots grow into bigger patches. The skin on the patches becomes thin and wrinkled. Then the skin tears easily, and bright red or purple bruises are common. Sometimes, the skin becomes scarred.
InLichen Sclerosis the main symptom is itching along with painful coition, urination and defecation.
In males Lichen Sclerosis can lead to whitish thickening of foreskin of penis causing phimosis (failure of foreskin to be fully retracted from the head of the penis)

Diagnosis:

Lichen Sclerosis diagnosis is done by experienced clinical examination and
biopsy of skin may be required to confirm the diagnosis.

Conventional Treatment:

1.Application of strong cortisone or immunosuppressant (ointments or creams) is suggested such as clobetasol propionate and tacrolimus
2.Topical oestrogen creams are not effective for Lichen Sclerosus but may be prescribed for postmenopausal atrophy (dry, thinned and sensitive vulval and vaginal tissues due to hormonal deficiency).
3.Retinoid, or vitamin A-like drugs
4.Surgery to remove entire vulva in severe cases, vulvar cancer or pre-cancer.
5.Surgery which removes the patches in women is of no use as it comes back
6.Circumcision in men
7.Ultraviolet light therapy (not used on skin of the genitals).

Homeopathic treatment:

Homeopathic treatment entails medication based on the understanding of immune-status of the patients, and other genetic, hormonal, stress related factors. Some of the commonly used medicines include ultra-small doses of potentized mercury compounds, gold salts, Thuja occidentalis, some nosodes, etc.

Prognosis of Lichen Sclerosis:

There is an increased risk of cancer in the long-term; Women with Lichen Sclerosis may develop vulvar carcinoma. In advanced cases, skin that has been scarred as a result of Lichen Sclerosis may cause sexual difficulties or problems in passing urine

Some general measures:

Use of moisturizers or bland creamsAvoid soap, bubble baths, scented soap, detergents, perfumes, etc, to the vulva. These may irritate the skin and make symptoms worse.Lubricants are useful during sex if having sex is painful.Avoid tight clothing and use cotton under garments

Homeopathic Remedies for Lichen Planus

What are the sources of homeopathic medicines?

The homeopathic medicines are prepared from a wide range of natural sources. Over 5% of the medicines origin largely from the vegetable kingdom, i.e. flowers, roots, leaves and the juice.
Certain chemicals and minerals are also used to prepare certain medicines. For instance, sulfuric acid, nitric acid. Most of the minerals and metals are used as a source of medicine, such as gold, silver, zinc, tin, iron and so on. Some microbes, bacteria, virus are also used to prepare a special group of medicines (called Nosode), for instance, influenza virus, certain bacteria, etc. Some body secretion such as the hormones (thyroid hormone, for instance) also find place in the wide source-place. The animal kingdom has a special place in the Homeopathy pharmacy and Homeopathy medicines are prepared from the animal sources almost in a onviolent technique.

How are the homeopathic medicines prepared?

The revolutionary method of drug preparation in Homeopathy, called as Potentization, utilizes a very minute quantity of the original drug substance. A very small portion of any substance, say a drop of Thuja herbal extract, as one part, is mixed with 99 parts of alcohol or distilled water. Some powerful strokes are given to this mixture of about 100 drops/ml. It makes 1c potency. (Potency is the unit indicating the strength of medicine.) Now, out of these 100 drops, one drop is taken and mixed with 99 drops of alcohol, again to undergo the process of vigorous strokes, making the potency 2c. The process is continued higher level up to 30c, 200c, 1000c, 10000c, 50000c, and 100000c.

No material, only the medicinal power…

As you can realize, there is infinitesimal original drug substance in the higher potency medicines. Actually it crosses the Avogadro’s limit. There is no detectable material in the potency higher than 24. What is left behind is the power or energy of the medicine. One may call it dynamic power, which is capable to induce definite changes in the body system to bring about the healing process.

Absolutely safe and non-toxic:

As you can see that the special method of homeopathic medicines render them absolute free from any toxic substance in it. The medicines thus are absolutely safe and free from any side effects. They are safe for even babies and pregnant women.

Lichen Planopilaris

What is Lichen Planopilaris?

Lichen Planopilaris is also known as follicular Lichen Planus or Lichen Planus follicularis. It is a variant of Lichen Planus (LP) of the scalp which leads to scarred alopecia followed by permanent hair loss on the scalp. It is an autoimmune disorder.
(Hair follicle is a small tubular cavity containing the root of a hair; small muscles and sebaceous glands are associated with them)

Pathology:

The histological hallmark of Lichen Planopilaris is a chronic per follicular and interface dermatitis that affects the hair follicle infundibulum (the segment that extends from the entrance of the sebaceous gland duct to the follicular orifice) and isthmus (the short segment that extends from the insertion of the erector pili muscle to the entrance of the sebaceous gland duct). This leads to destruction of basal keratinocytes in the hair follicle.

Symptoms of Lichen Planopilaris:

Lichen Planopilaris mainly affects middle aged people, more common in men. This type of LP exhibits primarily as skin flaking, hair loss and pruritis (severe itching).
It is manifested by tiny red spiny papules around a cluster of hairs. Sometimes even blistering occurs in the lesions. In some cases, no follicular scaling or inflammation is present but bald areas of scarring slowly appear.
It can be multi-focal or central alopecia patches with follicular hyperkeratosis or hardening and erythema or redness at the hair-bearing margin.

Diagnosis:

Lichen planopilaris on scalp Convincing cases of Lichen Planopilaris include a combination of typical Lichen Planus lesions and scarring alopecia. Those cases presenting only as scarring alopecia of scalp require histological co-relation (i.e. biopsy) for exact diagnosis.
Research say’s that up to 40% of scarred alopecia is due to Lichen Planopilaris.

Conventional Treatment:

In conventional therapy the treatment generally comprises of short tapered courses of prednisone in combination therapy with retinoids or anti-malarial drugs.
Other options include psoralen-UV-A, systemic and topical steroids, etc but its efficacy for the treatment is not proved.

Scope of homeopathy:

Lichen Planopilaris should be treated as quickly as possible to avoid permanent hair loss. Treatment is case- dependant, as severity of symptoms, extent of the lesions and response to treatment vary from individual to individual.
If not treated in early stages, it may lead to permanent loss of hair and in such cases homeopathy is helpful to stop the further progress of the disease.
Homeopathy is strongly recommended in the initial stages of Lichen Planopilaris wherein we can help to control the further progress of the disease. It is not possible to grow hair on the scalp which has scarred skin. Good control of further deterioration is also considered as significant treatment using homeopathy.