Introduction

Lichen planus is an inflammatory skin condition, characterized by an itchy, non-infectious rash on the arms and legs. It consists of small, many-sided, flat-topped, pink or purple bumps. Considered to be an autoimmune disease, it typically occurs in people over the age of 30 years. It occurs more in females than in males. People with liver diseases, such as hepatitis C or cirrhosis are more susceptible to lichen planus.

Signes et symptômes

Itchy, discoloured patch or patterns of shiny, raised, red, pink, or purple, flat-topped bumps on skin.

Papules, approximately 3 to 5 mm in diameter.

White streaks may sometimes appear on the papules, called Wickham’s striae. Intense itching may occur, especially at night.

Symptoms vary depending on the site of the condition.

The first attack can continue for weeks, and even months, while recurrences can go on for years. Recurrence is common in cases of oral lichen planus.

Most affected areas are the wrists, elbows, ankles, and lower back. However, other parts of the body may be affected. The shins can be affected by thickened lichen planus, while the armpits might have ring-shaped lichen planus.

Oral lichen planus

• White streaks appear on the inside of the cheeks. The gums, tongue, and lips may also be affected.
• The streaks are not usually painful or itchy but they do not resolve.
• Redness and blistering of the gums.
• Sore mouth ulcers can develop and recur.
• Loss of taste, metallic taste in mouth.
• Dryness of mouth.

Lichen planus of the penis

• Purple or white ring-shaped patches appear around the head of the penis.
• They are not usually itchy.
• Symptoms are similar to thrush, and often mistaken for it.

Lichen planus of the vagina and vulva

Typical white streaks develop on the vulva which are not itchy or painful.

Lichen planus on labia minora, and the entrance to the vagina will recur often, and the affected mucous membrane will be bright red and raw. The labia minora may also shrink and stick to labia majora.

The vagina will become red. Scar tissue can distort the shape of the vagina. Lichen planus can affect deeper areas within the vagina, causing desquamative vaginitis. Discharge can occur when the surface cells in the vagina peel off. The eroded vagina will easily bleed when touched.

Sexual intercourse will be painful, difficult, or impossible.

Lichen planus follicularis

This affects areas in which hair grows, such as the scalp. There may be redness and irritation. This type of lichen planus sometimes causes hair loss, which can be permanent.

In extremely rare cases, lichen planus can occur in the anus, ear canal, eyelids, and oesophagus.

Causes

The exact cause of lichen planus is still not known.

It is considered to be autoimmune disorder, where the immune system mistakenly attacks healthy tissues.

Hereditary factors do not play any role in this condition.

It is not an infectious condition

It is not related with malnourishment/deficiencies. However, spicy foods, citrus juices, and tomato products may aggravate symptoms if there are open sores in the mouth.

Some causes of lichen planus are thought to involve the following:

Medications: Lichen planus can occur as a reaction to certain medicines, including:

• Beta-blockers, which are common drugs used to treat cardiovascular problems
• anti-inflammatory medications
• antimalarials
• thiazide diuretics
• phenothiazines, a group of tranquilizing drugs with antipsychotic actions

Mercury tooth fillings: Some studies have found a link between lichen-planus-type changes in the mouth and an allergic reaction to mercury tooth fillings.

Lichen planus can also be part of Grinspan’s syndrome, a syndrome characterized by hypertension, diabetes, and oral lichen planus.

Diagnostic

Physical examination due to its appearance.

A punch biopsy of skin

Traitements

Treatment for lichen planus may include antihistamines, phototherapy, or steroid creams/tablets.

Antihistamines may be used to treat itching in severe cases of lichen planus.

Lichen planus is not a curable condition.

Cyclosporin capsules or acitretin tablets can reduce the activity of the immune system and may sometimes help. They are only used in extremely severe cases.

For lichen planus that occurs in the mouth, the doctor may prescribe steroid lozenges or mouthwashes if mouth ulcer symptoms become uncomfortable.

For lichen planus of the mucous membranes, treatment can be difficult to get right and may take years. The doctor may prescribe corticosteroids to be taken as tablets.

Fortunately, oral lichen planus causes few problems and treatment is not usually required. Oral hygiene can be poor among people with oral pain, which makes it even more important to maintain good oral hygiene.

Pronostic

Usually, mild lichen planus on the skin clears up on its own in some months to years.

Moderate cases subside within some weeks to months with treatment.

Some cases where the disease affects mucous membranes are resistant to treatment and prone to recur.

Complications

Permanent brown or grey marks on the skin

In rare cases, persistent skin lesions and mouth ulcers may increase the risk of developing cancer by a small amount.

Maladies et Ayurveda

Keloid  – Charmakushtha

Nidana

Unwholesome diet with opposite potency

Routine et comportement inappropriés

Taquiner et humilier d'autres personnes bienveillantes

Vol

Mauvaises actions qui provoquent un stress émotionnel facteurs comme le repentir/la peur/l'anxiété

Kapha-Vaatadoshakopanidana            – causes for vitiation of all the kapha and Vaatadosha            

Purvaaroopa

Absence de transpiration

Perte de la sensation tactile

Samprapti

Due to the causative factors, vitiated doshas (mainly kapha& Vaata) vitiate rasadhatu and reaches skin. It settles on the skin and develop into thick and hard skin rashes.

Lakshana

Hasticharma    – thick skin like that of elephant

Kharasparsam - Dur/transparent au toucher

Divisions

Non mentionné

Pronostic

Akrichram ou yaapyam

Chikithsa

Samana

Pralepa avec lekhanadravya

External application of ghrita after aamapachana

Sodhana

Snehana

Swedana

Virechana

Ksharakarma

Médicaments couramment utilisés

         Aragwadhadi kashayam

Patolamuladi kashayam

Thriphalachoornam

Arogyavardhini vati

Jathyadi ghrutam

Marques disponibles

AVS Kottakal

AVP Coimbatore

Vaidyaratnam oushadhasala

Remèdes maison

While lichen cannot be cured, some home remedies have been said to relieve symptoms.

Turmeric has been suggested as a remedy for oral lichen planus as it has shown effects on the immune system that could help reduce the inflammation that contributes to the condition.

A recent pilot study demonstrated promising results for this herbal treatment.

Other suggested treatments include:

• applying certain oats, to the skin
• chewing sage
• applying aloe vera gels to the skin
• essential oils
• borax

However, there appears to be little to no evidence supporting the safety and effectiveness of these treatments.

It is better to follow a course of treatment prescribed by a medical professional.

Régime alimentaire

• À éviter

Red meat, fried non-veg items, and sea foods

Les repas lourds et les aliments difficiles à digérer provoquent des indigestions.

La malbouffe et les plats épicés - perturbent la digestion et réduisent la biodisponibilité du médicament.

Boissons gazeuses - rendent l'estomac plus acide et perturbent la digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni (digestive fire)

Caillé - provoque le vidaaha et, par conséquent, de nombreuses autres maladies

• A ajouter

Des repas légers et des aliments faciles à digérer

Gramme vert, soupes, babeurre bouilli avec du curcuma, du gingembre et des feuilles de curry.

Aliments fraîchement cuits et chauds traités avec des graines de cumin, du gingembre, du poivre noir, de l'ajwain, etc.

Comportement :

Avoid sedentary lifestyle. Be active.

Il est préférable d'éviter une exposition excessive à la lumière du soleil, au vent, à la pluie ou à la poussière.

Maintenir une alimentation et un sommeil réguliers.

Évitez de forcer ou de retenir les envies naturelles comme l'urine, les selles, les vomissements, le hoquet, etc.

Évitez autant que possible le stress et les déséquilibres émotionnels.

postures de Yoga

Ardha mathsyentra asanam

Halasanam

Vakrasanam

Dhanurasanam

Tous les exercices et les efforts physiques doivent être décidés et effectués uniquement sous la supervision d'un expert médical.

Articles de recherche

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541468/