BEST post i have seen by far comes from osteopaths…. that says something about this group.
and then i read the American Skin Association’s site and it looks pretty much the same… go figure.  Lichen planus is a relatively common skin disease that comes in episodes lasting months to years. The onset may be gradual or quick, but its cause, like many skin diseases, is unknown. It appears to be a reaction in response to more than one provoking factor. Theories include stress, genetics, infective (viral hepatitis C) and immunologic (autoimmune). There are also drugs that produce lichen planus-like allergic reactions to high blood pressure, heart disease, and arthritis medications. There is an inherited form also which is often more severe and can have a protracted course.

Lichen planus appears as shiny, flat-topped bumps that often have an angular shape. These bumps have a reddish-purplish color with a shiny cast due to a very fine scale. The disease can occur anywhere on the skin, but often favors the inside of the wrists and ankles, the lower legs, back, and neck. The mouth, genital region, hair and nails are affected in some individuals. Thick patches may occur, especially on the shins. Blisters may rarely occur. Bumps may appear in areas of trauma on some individuals. About 20 percent of the time lichen planus of the skin causes minimal symptoms and needs no treatment. However, in many cases the itching can be constant and intense.

This disease occurs most often in men and women between the ages of 30 and 70 years. It is uncommon in the very young and elderly. All racial groups seem susceptible to lichen planus.

There is no known cure for skin lichen planus, but treatment is often effective in relieving itching and improving the appearance of the rash until it goes away. Since every case of lichen planus is different, no one treatment does the job. Topical corticosteroids are very useful. Antihistamines may be prescribed to relieve itching. Extensive cases may require the use of oral corticosteroid (cortisone, prednisone) for a number of weeks. This usually shortens the duration of the outbreak. For severe cases powerful treatments include photo chemotherapy light treatment (PUVA), the retinoids drugs (Soriatane and Accutane), cyclosporine and hydroxychloroquine.

Other helpful measures include soothing baths (Aveeno Colloidal Oatmeal, Nutrasoothe) and the application of wet dressings (tap water, Burows solution 1:40) to the affected areas to help reduce itching. Also, the use of lotions containing anti-itch ingredients such as menthol, pramoxine and phenol (Sarna, Aveeno cream, Prax, Itch-X) may be helpful.

As it heals, lichen planus often leaves a dark brown discoloration of the skin. Like the bumps themselves, these stains may eventually fade with time without treatment. About one out of five people will have a second attack of lichen planus.

for those of you out there (like me) that have the misfortune to experience this….. blessings to you.
I was not very impressed with the general practitioner, the first resident dermatologist, second resident dermatologist, or the attending staff that I have seen about this, NOW DIAGNOSED BY MICROSCOPY, disorder. I am calling it a disorder because to me a disease is caused by an infectious agent. Diseases and disorders both may have known and unknown causes. A disorder in my mind is more a “out of order function” which may be caused by an agent (any environmental influence) but the basic processes involved in the reaction are normal processes gone ary. Compare, bacterial endotoxins, or agents that cause infections like viruses and bacteria,
From what I have read lichens planus resembles some excellerated immune response. Histologically the presence of Langerhans cells, lymphocytes, changes in the mitotic rates of the basal and lower levels of the epidermis. I even think that what I have been reading about lately (cell adhesion molecules) might be involved since not only does the epidermal layer of the skin (in lichen planus) look different, but several mentions of decreased desmosomes between/among keratinocytes occurred. This could be related directly or indirectly to the disorderly processes of this condition.

Dont bother googling the pictures for this disorder… ha ha…. too scary.