A condition affecting many tissues in the body including the skin. Cutaneous lichen planus affects skin and causes swelling and irritation. It is most common in middle-aged adults and is not infectious or contagious. It occurs when the immune system attacks the cells of the skin and/or the mucous membranes in the body. Lichen planus is typically diagnosed clinically but can also be confirmed after a skin biopsy, which would also rule out certain types of cancer.
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Symptoms
Lichen planus will present as a rash that appears purplish with flat papules, bumps or plaques that can increase in size from the tip of a pin to the width of a pencil or larger. It may be scattered over the legs, clustered or form a linear pattern. This rash may be itchy and erupt on other areas of the body, not just the legs. If scratching leads to a break in the skin, wounds can develop as a complication. Additionally, hair loss on the legs in the area of the rash can also occur.
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Causes
Lichen planus occurs when the immune system attacks the skin and/or mucous membranes, but the exact cause of this attack is unknown. There are several contributing factors that may increase a person’s risk for developing lichen planus. Causes may include: genetic predisposition, age, physical or emotional stress, injury to the skin, systemic viral infection and medications used to treat arthritis, high blood pressure and heart disease.
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Treatment
To avoid exacerbating the rash, it is best to use a mild soap to gently wash the legs. General care includes daily application of a moisturiser to maintain the moisture of the skin. An oral antihistamine can help ease itchiness especially at night when trying to sleep. Specific treatment is not always necessary as lichen planus can be self-limiting but the goal of treatment is relieving itching or pruritus. Seek the advice of a medical footcare clinician or primary care professional to discuss treatments such as topical corticosteroids, retinoids, oral steroids or phototherapy if self-treatment at home is not effective.
