HOMOEOPATHIC REMEDIES FOR LICHEN PLANUS PIGMENTOSUS , LPP

 Lichen planus pigmentosus ( LPP ) was first described by Bhutani et al. in 1974. This disease of unknown etiology runs an insidious and prolonged course and is characterized by macules of dark brown color distributed principally in the sun-exposed areas of the body. The disease may involve the mucosa but spares the scalp and nails. They named the disease ‘ Lichen planus pigmentosus ‘. It has been reported to occur predominantly in persons with darker skin and may occasionally be accompanied by pruritus. Cases have been reported from India, Japan, Korea, the Middle East, and Latin America.

The disease starting insidiously after the age of 30. It occurs  in both sexes but shows  a female preponderance.

Lichen planus pigmentosus is a rare variant of cutaneous lichen planus characterized by the presence of hyperpigmented lesions in sun-exposed or flexural areas of the body.

Symptoms

·         The disease usually starts on the face and neck, spreading later to the upper extremities and trunk

·         Relatively rare sites of involvement are the oral mucosa and folds such as axillae, inframammary areas and groin.

·         Intinally the lesions are asymptomatic or mildly pruritic. Then the initial lesions are small, brown , oval macules with diffuse borders.

·         Later they merge to form pigmented areas which are gray or brown

·         The pigmentation may be diffuse, reticulate or perifollicular

·         The patches are usually symmetrical in distribution, but may be found in a segmental, zosteriform or blaschkoid pattern.

Causes

Although the etiology is essentially unknown , a number of agents have been reported to act as predisposing factors.

The occurrence in exposed areas in many patients has led to the proposition that sunlight may be a principal etiological agent.

Other postulated agents are hepatitis C virus, mustard oil which contains the potential photosensitizer allyl thiocyanate, amla oil where the photosensitivity may be caused by fragrances, cosmetic agents such as kumkum, hair dyes, etc

Abnormalities in T-lymphocyte functions have also been implicated.

It can be induced by gold therapy .

Lichen planus pigmentosus has been associated with scarring alopecia and circulating antinuclear antibodies; frontal fibrosing alopecia; acrokeratosis of Bazex and head and neck carcinoma; hepatitis C infection, and nephritic syndrome.

Prognosis

Lichen planus pigmentosus  seems to follow a chronic nature

HOMOEOPATHIC REMEDIES

Homoeopathy today is a rapidly growing system and is being practiced all over the world. Its strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental , emotional , spiritual and physical levels. When LPP  is concerned there are many effective medicines are available in Homoeopathy, but the selection depends upon the individuality of the patient , considering the mental and physical symptoms.

ANTIMONIUM CRUDUM  30---Antimonium crudum is considered for LPP , where the skin is dry with measles like eruptions. Intense itching, which is worse from the heat of bed. Eruptions with burning and itching, worse at night. Skin is sensitive to cold bathing. LPP with gastric derangements.

LACHESIS 0/3—Lachesis is prescribed where the skin has a bluish, black appearance. Eruptions  with bluish purple appearance. The patient cannot bear anything tight anywhere. Sensation of constriction in the throat, abdomen and head.

THUJA OCCIDENTALIS 1000—Thuja occidentalis is effective for LPP with hyperpigmented brown colored spots. These spots are seen on face, hands and arms.Skin very sensitive to touch. Violent itching and burning, worse cold bathing.

SULPHUR IODATUM 30—Sulpjur iodide is prescribed for LPP with papular eruptions on the face. Papular eruptions with constant itching. Itching on ears and neck.