Cancer Association of South Africa (CANSA)

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1 Cancer Assciatin f Suth Africa (CANSA) Fact Sheet n Lichen Planus Intrductin Lichen planus (LP) is a disease f the skin and/r mucus membranes that resembles lichen. A lichen is a cmpsite rganism that emerges frm algae r cyanbacteria (r bth) living amng filaments f a fungus in a mutually beneficial (symbitic) relatinship. The whle cmbined life frm has prperties that are very different frm prperties f its cmpnent rganisms. [Picture Credit: Lichen Planus] The cause f lichen planus (LP) is unknwn, but it is thught t be the result f an autimmune prcess with an unknwn initial trigger. There is currently n specific cure, but many different medicatins and prcedures have been used t cntrl the symptms. (Wikipedia). Lichen Planus (LP) Lichen planus is a chrnic recurrent rash that is due t inflammatin. The rash is characterised by small, flat-tpped, many-sided (plygnal) bumps that can grw tgether int rugh, scaly plaques n the skin. There may als be a rash in the lining (mucus membranes) f the muth r vagina. Lichen planus is a very curius and prly understd skin cnditin. Its name is descriptive in that t sme it resembles a simple plant, a lichen, that grws n rcks and tree bark, while planus is Latin fr flat. (MedicineNet). Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health] Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2017 Page 1

2 Incidence f Lichen Planus (LP) in Suth Africa Because Lichen Planus is nt a type f cancer, there is, therefre, n infrmatin regarding this cnditin in the Natinal Cancer Registry f Causes f Lichen Planus (LP) The cause f lichen planus is unknwn, thugh strng evidence suggests that inflammatin, cntrlled by the immune system, gives rise t the lesins. Hwever, certain diseases, medical cnditins r ther factrs may act as triggers f lichen planus in sme peple. The pssible triggers f lichen planus include: Hepatitis C infectin Hepatitis B vaccine Influenza vaccine Certain pigments, chemicals and metals Nnsteridal anti-inflammatry drugs, such as ibuprfen (Advil, Mtrin IB, thers) and naprxen (Aleve, thers) Certain medicatins fr heart disease, high bld pressure r arthritis (May Clinic). Cmplicatins f Lichen Planus (LP) Ersive lichen planus is a lng-lasting (chrnic) frm f lichen planus that causes painful ulcers t develp, as well as burning and discmfrt in the genital areas f bth male and females. Occasinally, in arund 2% f cases, lng-term cases f ersive lichen planus can develp int certain types f cancer, such as: Cancer f the muth Cancer f the vulva Cancer f the penis (May Clinic). Persns at Risk f Lichen Planus (LP) Lichen planus can ccur in anyne at any age, but there are certain factrs that make sme peple mre likely t develp the cnditin. The skin frm f lichen planus ccurs in men and wmen equally, but wmen are twice as likely t get the ral frm. It is very rare in yung and elderly peple, and mst cmmn in middle-aged peple. Other risk factrs include having ther family members with lichen planus, having a viral disease like hepatitis C, r being expsed t certain chemicals that may act as allergens. These culd be antibitics, arsenic, gld, idide cmpunds, diuretics, and certain kinds f dyes. (Healthline). Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health] Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2017 Page 2

3 Signs and Symptms f Lichen Planus (LP) The signs and symptms f lichen planus depend n where it appears n the bdy. Skin - On the skin, lichen planus ften causes bumps that are shiny, firm, and reddish purple. Smetimes the bumps have tiny white lines running thrugh them. These lines are called Wickham s striae. Mst peple get a few bumps. Sme peple get many bumps, which can appear n different parts f the bdy. The mst cmmn places fr these bumps t appear are the wrists, lwer back, and ankles, but they can appear anywhere n the skin, including the genitals. On the legs, the bumps tend t be darker. New bumps may appear as lder bumps clear. When lichen planus develps n the skin, a persn can have the fllwing: Thick patches f rugh, scaly skin. If bumps cntinue t appear in the same place, thick patches f rugh, scaly skin can frm. These patches develp with time and are mst cmmn n the shins and arund the ankles. Itch. Smetimes the bumps and patches itch. The thick patches are mst likely t itch. Blisters. These are rare. Pain, especially n the genitals. The skin can be bright red and raw. Open sres can appear. These can make sex painful r impssible. Muth (ral lichen planus) - When lichen planus appears inside the muth, it mst cmmnly ccurs n the insides f the cheeks. It als can appear n the tngue, lips, and gums. Inside yur muth, yu may have: Patches f tiny white dts and lines that can lk like lace. Redness and swelling. Peeling n the gums. Painful sres (can hurt r burn). [Picture Credit: Oral Lichen Planus] Nails - When lichen planus appears n the nails, it ften appears n just a few nails. Smetimes it appears n all f the nails n a hand r ft. One may see: Ridges r grves n the nails. Splitting r thinning. Lss f nails (can be temprary r permanent). [Picture Credit: Lichen Planus f the Nails] Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health] Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2017 Page 3

4 Scalp (lichen planpilaris) - It is rare, but this disease can develp n the scalp. If it des, the persn may have the fllwing n his/her scalp: [Picture Credit: Lichen Planus f the Scalp] Redness and irritatin. Tiny bumps. Thinning hair r patches f hair lss. Scars which appear slwly (American Academy f Dermatlgy). Genital Lichen Planus - is an inflammatry disease that can cause an itchy r burning rash, r painful purple lesins, n the skin f the arms r legs, r inside the muth. It can als affect bth male and female genitals. [Picture Credit: Lichen Planus f the Vulva] [Picture Credit: Lichen Planus f the Penis] Treatment f Lichen Planus (LP) Mst f the time, the bumps g away withut any treatment after abut a year. Hwever, treatment can make the skin lk better. The gal f treatment is t reduce yur symptms and speed healing f the skin lesins. If symptms are mild, n treatment may be needed. There is n knwn cure fr skin lichen planus, but treatment is ften effective in relieving itching and imprving the appearance f the rash until it ges away. Lichen planus f the scalp must be treated right away, r the hair f the affected area may never grw back. Since every case f lichen planus is different, n ne treatment des the jb. Tpical crticsterids are very useful. Yu can use a crticsterid intment r cream that yu apply directly t the bumps. Crticsterids may be injected directly int a lesin. In the muth, sterid pastes r inhalant pwders may be easier t apply t affected sites. Hydrcrtisne fam can be used inside the vagina. Antihistamines may be prescribed t relieve itching. Extensive cases may require the use f ral crticsterid fr a few weeks r lnger. This usually shrtens the duratin f the utbreak, but may have serius side effects. Ultravilet light therapy (als called PUVA) may be beneficial in sme cases. The s-called immune mdulating drugs, tacrlimus intment and pimecrlimus cream, may be useful fr ral and genital lichen planus. Other treatment ptins include tpical r ral retinid (a frm f vitamin A), lng term antibitics, ral antifungal agents, phttherapy, methtrexate, and hydrxychlrquine. (American Skin Assciatin). Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health] Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2017 Page 4

5 Medical Disclaimer This Fact Sheet is intended t prvide general infrmatin nly and, as such, shuld nt be cnsidered as a substitute fr advice, medically r therwise, cvering any specific situatin. Users shuld seek apprpriate advice befre taking r refraining frm taking any actin in reliance n any infrmatin cntained in this Fact Sheet. S far as permissible by law, the Cancer Assciatin f Suth Africa (CANSA) des nt accept any liability t any persn (r his/her dependants/estate/heirs) relating t the use f any infrmatin cntained in this Fact Sheet. Whilst CANSA has taken every precautin in cmpiling this Fact Sheet, neither it, nr any cntributr(s) t this Fact Sheet can be held respnsible fr any actin (r the lack theref) taken by any persn r rganisatin wherever they shall be based, as a result, direct r therwise, f infrmatin cntained in, r accessed thrugh, this Fact Sheet. Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health] Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2017 Page 5

6 Surces and References American Academy f Dermatlgy American Skin Assciatin Healthline Lichen Planus Lichen Planus f the Nails Lichen Planus f the Penis Lichen Planus f the Scalp Lichen Planus f the Vulva May Clinic MedicineNet Oral Lichen Planus Wikipedia Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health] Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2017 Page 6