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Weak Nailbeds and Skin Lesions? Managing Lichen Planus

If you notice that your toenails are thinning or splitting, or if you notice purplish flat bumps on your skin, you may be dealing with an inflammatory skin condition called lichen planus. Make sure to visit a dermatologist for a diagnosis and to rule out other similar skin conditions. Read on to learn more about this condition and how to treat it.

What Are Some Symptoms of Lichen Planus?

A lot of people may not realize they have lichen planus because the symptoms can vary widely, and they can be similar to other skin conditions. Lichen planus can cause swelling and irritation on your skin, scalp, nails, and mucous membranes.

Some other symptoms you may experience are:

  • Itchiness
  • Lacy white patches inside your mouth or on your tongue
  • Hair loss or changes in scalp color
  • Nailbed damage or loss
  • Lesions

While a lot of bumps will appear purplish, others may present in various forms, such as blisters or ring-shaped bumps. These bumps mainly form on the ankles, hands, wrists, forearms, and sometimes the genitals.

What Causes This Skin Condition?

If the immune system attacks the body’s skin and mucous membranes, you can develop lichen planus — people with autoimmune diseases are especially prone to this skin condition.

However, lichen planus can also be triggered by:

  • A reaction to certain metals, pigments, or chemicals
  • Certain medications for arthritis or heart disease
  • Certain pain relievers
  • Hepatitis B or C

Lichen planus can manifest as an acute infection or a chronic issue. In many cases, it goes away on its own. However, you should see a dermatologist anyway since you may have a case of chronic lichen planus. If lichen planus doesn’t resolve on its own, it can leave scars, increase your risk of hearing loss and oral cancer, and cause sexual dysfunction.

How Is It Diagnosed?

Your dermatologist may do a physical exam of your skin to look for telltale lesions. Your dermatologist may also do a punch biopsy. During a punch biopsy, your dermatologist will use a circular tool to remove a small sample of skin. They will then use a few stitches to close the wound. Your dermatologist can look at that skin sample under a microscope to confirm a diagnosis of lichen planus and rule out other skin conditions.

How Can You Treat It?

Your dermatologist may set you up with some steroid creams so that you can get relief from any redness and inflammation. If you have a more severe case, then your doctor may recommend that you take steroid tablets orally. For different strains of this disease — and for bumps on fingers and toes — your doctor may prescribe an oral retinoid as a secondary line of defense.

If your lichen planus is caused by allergies, like to certain metals, then you may want to use antihistamines to reduce the swelling and itchiness.

Some dermatologists offer phototherapy with ultraviolet (UV) light to reduce symptoms. UV light can penetrate the skin and slow the growth of inflammatory skin cells. If you have other skin conditions in conjunction to lichen planus — like psoriasis — UV therapy could be a good option. It may take about six to eight treatments to relieve symptoms.  

If you have bumps on your mucous membranes, like inside your mouth, it may be painful to eat or talk. Your doctor could prescribe medicated mouthwashes or lozenges to reduce the pain.

Lastly, if your doctor determines that the lichen planus was caused by a medication for another condition, like to treat arthritis, you may need to look into alternatives so that you don’t develop chronic lichen planus.

Get in touch with us at East Carolina Dermatology and Skin Surgery, PLLC, today for more information.

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