What Causes Lichen Planus?
Lichen planus is a condition that produces lesions on the skin and mucous membranes. Some forms of the ailment also affect the hair and nails. Patients may notice they have itchy, purple lesions that spread across large areas of the body over several weeks or months. White streaks could form over the rash, and some lesions might blister. Painful ulcers may form in the mouth, and scalp discoloration and hair loss are common in cases where the disease affects the hair. In instances in which the nails are impacted, patients could experience thin, brittle nails, and nail loss may occur.
Doctors are normally able to diagnose lichen planus with a visual inspection and physical examination. In rare cases, a skin biopsy may be needed. Mild cases of lichen planus usually resolve without treatment. For more advanced cases, doctors may recommend light therapy, and antihistamines, retinoids, and corticosteroids might be prescribed.
Certain Medications For Heart Disease And High Blood Pressure
Patients taking certain medications for heart disease and high blood pressure are at a higher risk of developing lichen planus compared to those taking other medications. For example, beta-blockers (drugs that slow the heart rate and reduce blood pressure) are widely prescribed to treat hypertension and to treat abnormal heart rhythms. They are also used to help reduce the risk of a heart attack in patients who have previously experienced one.
ACE inhibitors are frequently used to prevent additional weakening of the heart in patients with congestive heart failure, and they are used to treat hypertension too. Individuals taking these drugs are at an increased risk of the oral form of lichen planus, and they frequently develop mouth sores. Studies suggest women taking ACE inhibitors or beta-blockers could be at a higher risk of developing lichen planus than male patients taking the same medications. Patients should always let their doctor know about any mouth sores or other troublesome side effects that occur while using these medicines.
Flu Vaccine
While the flu vaccine is considered safe and effective, some patients have developed lichen planus shortly after receiving the vaccine, and the vaccine is a recognized trigger for the condition. A Japanese study conducted in 2010 discussed three case studies in which patients developed lichen planus within two weeks after receiving the flu vaccine. A study published in December 2017 examined adverse events reported on the Vaccine Adverse Event Reporting System in the United States from July 1990 to November 2014. Of the 434,943 reported adverse events during this time, twenty-three cases of lichen planus were reported, and four cases of the oral form of lichen planus were reported.
The study authors noted an average patient age of forty-seven at the time of diagnosis, and more than fifty percent of the diagnosed cases were in female patients. In addition to the influenza vaccine, researchers found the hepatitis B vaccine and the Tdap (tetanus, diphtheria, and polio) vaccine were also associated with an increased incidence of lichen planus. The majority of cases were diagnosed within the first two weeks following vaccination, and some patients were diagnosed as late as 297 days post-vaccination. Individuals planning to receive any vaccine should speak with their healthcare provider about the risks and benefits of vaccination for their specific needs.
