Lichen planus is an inflammatory skin condition that can be itchy, painful and leave permanent scars.
lichen planus: an inflammatory condition of the skin; can be present anywhere on the skin, on the scalp, in the mouth, or on the nails
According to the American Academy of Dermatology, lichen planus affects about 1%-2% of the general population. There is little known as to the cause of the condition, but all theories include a reaction of the body’s immune system. The problem is doctors don’t know what causes the immune system to react. “There is no evidence of outside stimulus,” says Dr. Jere Mammino, D.O., a clinical dermatologist at Advanced Dermatology in Oviedo, Fla. “In a way, lichen planus is an auto-immune condition, because the immune system attacks the skin,” says Mammino. But even in this, lichen planus is an exception. “That term refers to genetic conditions such as rheumatoid arthritis or lupus,” he says. Yet, there is no conclusive evidence that lichen planus is genetic. Lichen planus can develop nearly anywhere on the body. On the skin, lichen planus “appears as rows of itchy, flat -topped bumps,” according to the Mayo Clinic. Lichen planus can also appear on the inside of the cheek and on the gums and tongue. Often a dentist will recognize the white lines and dots that are present in the mouth and send the patient to a dermatologist for diagnosis. Lichen planus also appears on the scalp (referred to as lichen planopilaris). On the scalp, lichen planopilaris can cause permanent damage to hair follicles and leave adults with patches of baldness. Of those affected with the condition, about 10% will have lichen planus on the nails, says Dr. Mammino. The condition can cause splitting or thinning of the nails. “It can be very difficult to diagnose,” says Mammino. One reason is it’s easy to confuse with other nail conditions, such as pterygium. Another roadblock to a diagnosis is the fact that lichen planus can show up on all the nails and toes, on only the nails or the toes, or on only select nails or toes. There’s no hard and fast rule for how or where lichen planus will appear on the nails. “It really is a diagnosis of exclusion,” says Dr. Lisa Hitchins, a Houston-based board-certified dermatologist. “There is no particular treatment for lichen planus of the nails,” says Hitchins. “There is really not a lot you can do.” When lichen planus appears on the skin, says Hitchins, two-thirds of patients will suffer for less than a year. Almost all of them will be clear by the second year. However, when lichen planus appears on the nail, it often destroys the matrix. Consequently, even if the lichen planus clears up, the nail will still be damaged. Lichen planus can be itchy, and it can cause inflammation. For these reasons, doctors sometimes prescribe steroids or suggest a cortisone shot at the base of the nail. These treatments don’t cure lichen planus, but they can provide clients relief from the itching or pain. Other recommendations for relief include a tepid soak or an over-the-counter antihistamine or a hydrocortisone cream. The good news is that lichen planus is not contagious and it’s not dangerous, so techs don’t have to fear contracting the condition or spreading it from client to client.