Lichenoid dermatitis is a skin disorder marked by itchy, inflamed, and purplish-colored patches on the skin. This disorder comes under the category of eczema but is very uncommonly developed.
It is caused by the damage to the epidermis by lichenoid which results in inflammation and problems with how the outer layer of the skin interacts with the next inner layer of tissue called the dermis. The condition is also known as lichen planus.
Lichenoid dermatitis is an immune-mediated disorder, meaning that the immune system started attacking the skin, resulting in a skin rash.
This disease most commonly affects elderly people but can occur throughout any time in life and is recognized by a purple coloring of the skin.
These rashes can occur anywhere on the skin like on the scalp, ankle, forearms or wrists, and lower back.
Even though lichenoid dermatitis is not contagious, it can indicate a more serious kin condition. The skin will heal on its own within two years, however, it can suddenly reoccur.
This article will cover homeopathic remedies for lichenoid dermatitis, the cause of lichenoid dermatitis, symptoms, risk factors, prevention and management, and complete treatment.
Causes of Lichenoid Dermatitis
Now the question arises why does lichenoid dermatitis form and what are the causes behind it. Before knowing the cause let us understand what is lichen?
Lichen is a composite organism and not a single organism consisting of a fungus and an alga functioning in a symbiotic relationship.
There are some causes linked with the development of lichenoid dermatitis that is mentioned below.
1. Particular medications
Many patients developed lichenoid dermatitis as a result of some medication given to treat conditions like hypertension, heart disease, arthritis, etc.
Lichenoid dermatitis is associated with many systemic medications such as ACE inhibitors, antihistamines, and NSAIDs. These medications can cause an allergic reaction in the patients and may later be developed into lichenoid eruptions or dermatitis.
2. Hepatitis C
Another most common cause of the development of lichen dermatitis is the Hepatitis C virus. It is seen that lichenoid dermatitis is frequently associated with chronic hepatitis C the erosive ulcerative type.
It is also accompanied by acute symptoms with significant functional disorders and affects the patient’s quality of life.
3. Autoimmune causes
Lichenoid dermatitis is thought to be caused by a t-cell-mediated autoimmune reaction against the epithelial layer of the skin in people with genetic disposition.
The T cells of the body identify the normal cells of skin and mucus membrane as foreign material and get activated and start destroying them, that further develop lesions in the body because of the actions taken against the body’s cells by T cells.
4. Defects in skin barrier
Skin barrier defect is another major cause of the development of many skins related issues especially lichenoid dermatitis and eczema.
The epidermis layer of the skin contains epithelial cells, immune cells, and some microbes that protect from allergens that can enter the skin and cause damage.
Due to some reason, the skin barrier gets defective and allows the pathogen to enter the skin that further resulting in the development of lichenoid dermatitis and other skin-related issues.
Lichenoid dermatitis can happen immediately after the beginning of any medication. After 3-4 months of taking the same medication again and again a person may develop lichenoid dermatitis.
Some drugs like ketoconazole, sulfa drugs, tuberculosis drugs, and tumor necrosis factor antagonists can later cause lichenoid dermatitis.
Types of Lichenoid Dermatitis
Other lichenoid dermatosis shares similar clinical presentation and tissue findings. The types of lichenoid dermatoses are mentioned below;-
1. Lichenoid drug eruptions
This type of lichenoid dermatoses is well known as drug-induced lichen planus and is the result of cutaneous adverse effects of most drugs.
Offending agents involved in lichenoid disorders are antimalarial, antidiuretics, antihypertensive, and non-steroidal anti-inflammatory drugs (NSAIDs).
2. Lichen planus
This type of lichen dermatoses is most common and mostly develops in elderly people due to various reasons among which the immune-mediated disorder is the most common cause.
The lesions are usually present as flat-topped purple rashes all over the skin, especially on the elbow, ankles, forehead, and forearms.
3. Lichen striatus
Lichen striatus is another type of lichenoid dermatoses that mostly occurs in children. The rashes developed on the skin that appears a light pink color and is scaly, flat bumps.
Over the following weeks, these bumps come together and join to form a line on the skin. It is majorly caused by an immunologic reaction to a viral infection.
4. Lichen nitidus
Lichen nitidus is a rare and uncommon inflammatory skin condition and usually appears as tiny skin-colored bumps on the skin.
It is mostly occurring in children due to an inflammatory response to some allergen. It has been considered a variant of lichen planus.
Symptoms of Lichenoid Dermatitis
The symptoms of Lichenoid dermatitis include: –
- Small red-purple bumps or rashes on the skin
- Red blisters on the skin
- Severe itching
- White scales or flakes on the skin
- Brittle, ridged nails
- Erythematous papules
- Discoloration of the skin
- Hyperpigmentation due to scratching
- Hyperkeratosis skin spears hard around the lesion
- Glistening bumps on the surface
- The rough oily look of the lesion
- Hair loss and scalp discoloration
- Crusted or weeping sores
- Brownish patches on hands, feet, and ankles
Risk factors of Lichenoid Dermatitis
- Those patients who are genetically predisposed which means this disease is running in their family are at higher risk of development of lichenoid dermatitis.
- As we know lichenoid dermatitis may develop due to hypersensitive or inflammatory reactions to certain medications. So, patients under certain medications like antihypertensive, and anti-inflammatory are more to develop lichenoid dermatitis.
- Lichenoid dermatitis can happen in age groups but mostly it is seen in elderly people between the range of 30 and 60 years of age group.
- Patients having weak immunity or having an autoimmune disorder may develop skin barrier defects in their life and are at great risk of developing many skins related issues including lichenoid dermatitis.
- Patients having diabetes mellitus and hepatitis are at great risk of occurrence of lichen dermatitis.
- If you live in a warmer climate and sweat a lot and also have prolonged exposure to water or some other irritant then you may develop lichenoid dermatitis.
- Along with immune disorders, stress, anxiety, and other factors can be a causative agent for the development of lichenoid dermatitis.
Diagnosis of Lichenoid Dermatitis
The diagnosis of Lichenoid begins with a complete medical history regarding onset, modalities, and severity of the disease and itchiness and physical examination, and is usually made by clinical examination that is by signs and symptoms experienced by the patients.
If you are experiencing the symptoms such as hyperpigmentation, severe itching not relive by scratching, burning on the skin, and rashes over the skin, then the doctor will perform some tests to confirm the diagnosis.
The doctor will ask about the medication and disease history that the patient is taking or whether the patient has hepatitis or diabetes or any autoimmune disorder or genetic disorder or not. Whether the patient is allergic to some medication or not etc.
The doctor will also ask about some associated symptoms along with dermatitis that patient may experiencing or not. If there is any seasonal variation or if the rashes appear after using certain perfumes or due.
The doctor may examine your skin, and he will also advise you for a skin biopsy to confirm the diagnosis and also it helps out to rule out other conditions.
Prevention and management of Lichenoid Dermatitis
- Some self-care measures can help to reduce the itching and burning of the skin that is caused by lichen planus such as avoiding scratching the skin to prevent the spread of infection. Instead of that gently rub the affected skin.
- Lichenoid dermatitis is caused due to some medications so discontinuation of such medications that are culprits can be effective.
- Keep your skin moistened because dryness may cause severe itching. Apply steroid cream such as cortisone cream and water-based moisturizer on the affected area every night before going to sleep.
- Do not use medicated or scented products that contain harsh chemicals. It will damage the skin and makes the condition worse.
- Take an oatmeal bath followed by moisturizing lotion. Dab the water on the body gently with a towel and do not harshly rub over the skin.
- Avoid smoking, alcohol consumption, and taking spicy or acidic food in case of oral lichen planus. These are the triggering agents for lichenoid dermatitis so it is better to be avoided.
- Proper counseling and assurance to the patients along with proper management can help a lot in recovery from such conditions.
Lichenoid Dermatitis Treatment – Best Homeopathic Medicines
Homeopathy is a holistic system of medicine that treats not only the symptoms of the disease but also the man who is suffering from the disease.
So, after a complete detailed history of present and past disease and considering the family history also, a drug is prescribed which will be based on the individualization of every patient.
In mild cases, improvement can be seen within weeks, whereas severe cases will take a longer time. Along with homeopathic medicine, the patients have to follow a healthy regimen for optimum results.
Now, let’s go through some of the homeopathic medicines that can help in Lichenoid dermatitis. Some of the best homeopathic medicines for the treatment of Lichenoid dermatitis are mentioned below.
- Antimonium crudum
- Arsenicum album
- Natrum muriaticum
- Apis mell
- Sulphur iodide
- Thuja occidentalis
- Nux vomica
- Merc sol
1. Antimonium crudum: for itching when warm in bed
Antimonium crudum is best suited for dry skin eruptions especially eczema due to gastric derangements. There is excessive irritability and fretfulness with a thickly coated white tongue.
It is indicated medicine in the treatment of lichenoid dermatitis when patients talk about their eruption becoming worse due to the warmth of the bed and mostly at night.
Scaly, pustular eruptions with burning and itching, worse at night.
Dosage and potency: 30c, 200c 4 globules (pills) dissolved in half a cup of water 2 times a day for 15 days.
2. Arsenicum album: for eruption worse by cold and scratching
Arsenicum is a polychrest remedy highly effective in treating many skins related issues. This remedy will be best suited when given constitutionally.
The eruptions are dry, rough, and scaly with severe itching and burning in them. Patients are inclined to scratch the lesion but doing this makes the condition worse.
There is burning pain relieved by heat and getting aggravated by warmth is one of the characteristics of this remedy. Patients are mentally restless and have the nocturnal aggravation of almost every symptom.
Dosage and potency: 200c, 4 globes in half cup of water thrice a day till the symptom disappear.
3. Sulphur: for lichenoid dermatitis after local medication
Sulfur is a great polychrest remedy known for its anti-psoric properties which means it is highly effective in treating almost all skin-related issues.
The skin of the Sulphur patients is unhealthy, there are pimple-like eruptions, pustules, and rhagades on the skin. There is severe itching around the eruption that becomes worse by scratching and washing.
It is best suited for the skin eruptions resulting after local medication. This remedy will work best if given constitutionally after the individualization of the patient.
Dosage and potency: 30c, 200c, take 4 drops of dilution in half a cup of water twice a day, till the improvement is seen.
4. Natrum muriaticum: for great oily kin and dry eruption
Natrum mur. is an effective medicine in treating lichenoid dermatitis. It is especially indicated to the patients having raw red and inflamed eczema that burns and itch severely.
This medicine is also indicated when there is crusty eruption present in the bends of limbs, margins of the scalp, and behind ears.
Patients are highly irritable, depressed, silent grief, and awkward. They want to be alone and cry and consolation make their condition worse.
Dosage and potency: 200c potency take 4 globules (pills) twice a day till the improvement occurs.
5. Borax: for lichenoid dermatitis due to overdosing on drugs.
Borax is a great polychrest remedy and is highly indicated by most homeopaths in treating skin-related issues including lichenoid reactions.
There is erysipelatous inflammation on the skin with swelling and tension. There is a stinging and itching sensation over the eruptions.
The patients get relived in cold weather and the condition becomes worse in warm weather. It is mostly indicated as a children’s remedy and has a dread of downward motion in nearly all complaints
Dosage and potency: 1m potency of dilution, take 2-3 drops in half cup of water one time a day for 3 days.
6. Apis Mell: for oral lichen planus
Apis is a wonderful remedy and highly effective in treating skin eruption developed after allergies, bee stings, any drug reaction, etc.
The main symptom calls for this remedy is a stinging and burning sensation with swelling of the affected part. It is used mostly in oral lichen planus. The tongue feels scalded, red hot, sore, and raw.
Swelling or puffing up of various parts, edema, stinging pains, soreness, and intolerance of heat is the guiding symptoms of this medicine.
Dosage and potency: 30c, 200c potency, take 2-3 drops of dilution in half cup of water and take twice a day till the improvement.
7. Sulphur iodide: for the popular eruption of the face
Sulfur iodide Lycoperdon holds a significant role among homeopathic medicines in treating skin-related issues and consequences of the excessive use of cosmetics.
It is a highly effective medicine for lichenoid dermatitis on arms, ankles, and elbows that is also covered with an itching rash.
Sulfur iodatum is indicated in obstinate skin affections, notably in barber’s itch and hyperemia and also in weeping eczema.
Dosage and potency: 30c, 200c, 4 globules (pills) twice a day till the improvement is seen.
8. Thuja occidentalis: for dry skin with brown spots and eruption on covered parts
Thuja occidentals are a great remedy for condylomata, warty excrescences, and spongy tumors. It is also seen as very effective in treating lichenoid dermatoses.
It is best suited when the patient develops hyperpigmentation, brown-colored spots, or purplish spots on the skin after scratching the eruptions again and again. The spots are marked on the face, hands, and arms and generally appear on the covered parts.
Eruptions are very sensitive to touch. The patient is also emotionally very sensitive and has fixed ideas
Dosage and potency: – 200c potency, take 4 globules thrice a day up to improvement.
9. Nux vomica: for lichenoid dermatitis in elderly people
Nux vomica is a great polychrest remedy and has an action on almost every organ of the body. It is frequently the first remedy indicated after overdosing and targets a wide range of chronic diseases.
The body of the patient is burning hot, especially the face yet cannot move or uncover without feeling chilly. It is indicated in lichenoid dermatitis, acne, and urticarial rashes with gastric derangements.
The patients who need Nux vomica are very irritable, and can’t bear noises, odors, light, etc. Highly disposed to reproach others and are fault-finding.
Dosage and potency: 30c, 200c take 3-4 drops of dilution in half a cup of water twice a day.
10. Merc sol: for lichenoid dermatitis due to free perspiration
Merc sol is indicated in the secondary stage of syphilis and also the lesion produced by mercury are very similar to those of syphilis.
It is indicated in treating lichenoid dermatitis when the lesion appears similar to that f syphilis and the skin of the patients remains constantly moist.
There is a general tendency to free perspiration, which is odorous and worse at night.
Dosage and potency: 30c potency, take four globules under the tongue, twice a day for 15 days or until the improvement appears.