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Encyclopedia of Health and Medicine

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lichen simplex chronicus A SKIN condition,<br />

sometimes called neurodermatitis, in which an<br />

itchy RASH erupts in response to continued<br />

scratching <strong>of</strong> the skin. Over time, the involved<br />

areas develop hyperkeratosis, an overgrowth <strong>of</strong><br />

keratinocytes that gives the areas a scaly, lichenlichen<br />

simplex chronicus 173<br />

mild bleaching action that reduces pigmentation<br />

in the areas <strong>of</strong> application. Cosmetic procedures<br />

such as dermatologist-performed chemical peel,<br />

hydroquinone application (a bleaching agent), or<br />

LASER SURGERY can diminish or eliminate lentigines<br />

<strong>and</strong> other blemishes on the face.<br />

See also SKIN SELF-EXAMINATION; SUNBURN; SUN<br />

PROTECTION.<br />

lesion A generalized term for any abnormal<br />

growth. Lesions can result from injury, disease, or<br />

surgery. Some lesions are malignant (cancerous)<br />

though most lesions are benign (noncancerous).<br />

Numerous types <strong>of</strong> lesions affect the SKIN. Their<br />

characteristics help define <strong>and</strong> diagnose disorders<br />

<strong>and</strong> conditions <strong>of</strong> the skin as well as systemic disorders<br />

that manifest dermatologic symptoms.<br />

COMMON TYPES OF SKIN LESIONS<br />

ACHROCHORDON ANGIOMA basal cell<br />

BIRTHMARK BLISTER carcinoma<br />

BULLA DERMATOFIBROSIS KELOID<br />

LENTIGINES MACULE malignant<br />

NEVUS NODULE melanoma<br />

PAPILLOMA PAPULE plaque<br />

PUSTULE SCALE SCAR<br />

squamous cell TELANGIECTASIS ulcer<br />

carcinoma VESICLE WHEAL<br />

See also DERMATITIS; PLAQUE, SKIN; PSORIASIS; RASH;<br />

SKIN CANCER.<br />

lice<br />

See PEDICULOSIS.<br />

lichen planus A common condition affecting the<br />

SKIN that appears as small, shiny, reddish purple<br />

(violaceous) bumps that itch, sometimes intensely.<br />

The bumps grow together in a scalelike pattern<br />

that resembles tree lichen. Lichen planus nearly<br />

always occurs in adults.<br />

Symptoms <strong>and</strong> Diagnostic Path<br />

Lichen planus typically erupts on the inner surfaces<br />

<strong>of</strong> the lower arms <strong>and</strong> wrists, along the shins<br />

<strong>and</strong> inner ankles, <strong>and</strong> along the lower back. Occasionally<br />

lichen planus appears on the scalp, where<br />

it can cause temporary or permanent ALOPECIA<br />

(hair loss), or affects the fingernails <strong>and</strong> toenails,<br />

causing ridges <strong>and</strong> grooves. In the MOUTH, lichen<br />

planus is light in color <strong>and</strong> the scaling more diffuse,<br />

creating a lacelike pattern lighter in color<br />

than the surrounding mucosa. The distinctive<br />

color <strong>and</strong> pattern <strong>of</strong> the RASH allow the dermatologist<br />

to make a quick diagnosis. The doctor may<br />

biopsy lichen planus lesions that appear in the<br />

mouth, as they resemble other conditions (such as<br />

CANDIDIASIS <strong>and</strong> precancerous lesions) that require<br />

different treatment.<br />

Treatment Options <strong>and</strong> Outlook<br />

Outbreaks <strong>of</strong> lichen planus typically retreat without<br />

medical intervention, though ANTIHISTAMINE MEDICA-<br />

TIONS <strong>and</strong> topical CORTICOSTEROID MEDICATIONS can<br />

help relieve the itching. In severe cases, the dermatologist<br />

may prescribe oral corticosteroids such as<br />

prednisone to suppress the IMMUNE RESPONSE. An<br />

outbreak may last several weeks to several months<br />

<strong>and</strong> typically flares in irregular recurrences over a<br />

period <strong>of</strong> years. Gentle, regular skin cleansing <strong>and</strong><br />

moisturizing can help to manage <strong>and</strong> reduce symptoms.<br />

Risk Factors <strong>and</strong> Preventive Measures<br />

Dermatologists do not know what causes lichen<br />

planus, though believe it is an immune response<br />

<strong>of</strong> some sort, either an autoimmune condition or<br />

an immune response to a VIRUS, likely with a<br />

genetic predisposition. Lichen planus also occurs<br />

in HEPATITIS C INFECTION, is an early sign <strong>of</strong> transplant<br />

organ rejection, <strong>and</strong> is a rare SIDE EFFECT <strong>of</strong><br />

some medications such as long-term therapy with<br />

the antimalarial medication quinidine <strong>and</strong> some<br />

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)<br />

used for OSTEOARTHRITIS. Avoiding exposure to substances<br />

that can cause lichen planus, when identified,<br />

usually prevents future outbreaks though<br />

some people continue to experience cycles <strong>of</strong> the<br />

condition for several years.<br />

See also AUTOIMMUNE DISORDERS; DERMATITIS;<br />

ICHTHYOSIS; LESION; LEUKOPLAKIA; LICHEN<br />

CHRONICUS; PRURITUS; PSORIASIS.<br />

SIMPLEX

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