What is the Difference Between Psoriasis and Lichen Planus

Psoriasis and lichen planus are two different skin conditions that cause itchy rashes on the skin.  These conditions can be chronic or long-term.

The key difference between psoriasis and lichen planus is their symptoms. Psoriasis can appear anywhere on the body while lichen planus mainly occurs inside the mouth, scalp, nails, and genitals. Moreover, lichen planus tends to cause more intense itchiness than psoriasis.

CONTENTS

1. Overview and Key Difference
2. What is Psoriasis  
3. What is Lichen Planus
4. Similarities – Psoriasis and Lichen Planus
5. Psoriasis vs Lichen Planus in Tabular Form
6. Summary – Psoriasis vs Lichen Planus
7. FAQ – Psoriasis and Lichen Planus

What is Psoriasis?

Psoriasis is an autoimmune skin disorder that causes skin cells to multiply up to 10 times faster than the normal level. The signs and symptoms of this condition may include skin rashes on lighter skin that appear red and are often covered with silver-colored scales. On darker skin tones, the rashes may appear dark brown or purplish with gray scales. Other symptoms include itchiness, changes in the color or small pits in fingernails or toenails, plaques, scales, or crust on the scalp, as well as pain and swelling in the joints. Psoriasis is due to an abnormal immune system reaction, which causes inflammation. The risk factors for this condition may include genes, alcohol consumption, and smoking.

Psoriasis can be diagnosed through physical examinations and lab tests such as skin biopsy. Psoriasis can be treated through various medications, such as steroid creams, prescription topical cream roflumilast, moisturizers, salicylic acid, coal tar, vitamin D-based creams, retinoids, calcineurin inhibitors, anthralin, methotrexate, cyclosporine, biologics (such as adalimumab and brodalumab), non-biologics (such as tofacitinib), enzyme inhibitors (such as apremilast and deucravacitinib), an aryl hydrocarbon receptor (AHR) agonist, light therapy, and alternative therapy.

What is Lichen Planus?

Lichen planus is a non-autoimmune skin condition that causes a rash to develop on one area of the body or several parts of the body, including skin, inside of the mouth, scalp, nails, and genitals (penis, vagina, and vulva). The signs and symptoms of lichen planus may in,clude tiny, raised dots on the skin, including the genitals, as well as tiny white spots that may appear on the skin inside the cheeks, tongue, or lips. Nails may change color, crack or split, stop growing, or fall off. The risk factors for this condition include hepatitis C infection, vaccines, NSA for IDS drugs, particular medications used to treat arthritis, heart disease, high blood pressure, and particular chemicals, metals, and pigments.

Lichen planus can be diagnosed through physical examination, allergy test, skin biopsy, and hepatitis C test. Furthermore, treatment options for lichen planus may include medications such as corticosteroids, antihistamines, phototherapy, immunosuppressants, retinoids (vitamin A derivatives), practicing good oral hygiene, minimizing trauma to the mouth, and replacing dental fillings.

Similarities Between Psoriasis and Lichen Planus

1. Psoriasis and lichen planus are two different skin conditions that cause itchy rashes on the skin.
2. Both these conditions can be chronic or long-term.
3. Both these conditions may have similar symptoms such as skin rashes, inflammation, nails falling off, etc.
4. These can be diagnosed through physical examination and skin biopsy.
5. They can be treated through specific medications and therapies.

Difference Between Psoriasis and Lichen Planus

Definition

1. Psoriasis is an autoimmune skin disorder that causes skin cells to multiply up to 10 times faster than normal levels and affect any part of the body.
2. Lichen planus is a nonautoimmune skin condition that causes a rash to develop on one area of the body or several parts of the body, including the skin, inside of the mouth, scalp, nails, and genitals (penis, vagina, and vulva).

Causes

1. Psoriasis is caused by an abnormal immune system reaction, which causes inflammation.
2. The cause of lichen planus is not known.

Risk Factors

1. The risk factors for psoriasis include genes, alcohol consumption, and smoking.
2. The risk factors for lichen planus include hepatitis C infection, vaccines, NSAIDs drugs, particular medications used to treat arthritis, heart disease, high blood pressure, particular chemicals, metals, and pigments.

Signs and Symptoms

1. Signs and symptoms of psoriasis include skin rashes on lighter skin that appear red and are often covered with silver-colored scales; the rashes may appear dark brown or purplish with gray scales on darker skin tones; itchiness; changes in the color or small pits in fingernails or toenails; plaques, scales, or crust on the scalp; pain and swelling in the joints.
2. Signs and symptoms of lichen planus include tiny, raised dots that may develop on the skin, including the genitals; tiny white spots that may develop on the skin inside the cheeks, tongue or lips; nails that may change colors, crack or split, stop growing or fall off.

Diagnosis

1. Psoriasis can be diagnosed by physical examination and lab tests such as skin biopsy.
2. Lichen planus can be diagnosed by physical examination, allergy test, skin biopsy, and hepatitis C test.

Treatment

1. Psoriasis can be treated with medications such as steroid creams, prescription topical cream roflumilast, moisturizers, salicylic acid, coal tar, vitamin D-based creams, retinoids, calcineurin inhibitors, anthralin, methotrexate, cyclosporine, biologic (adalimumab, broadalumab, etc.), non-biologic (tofacitinib), enzyme inhibitors (apremilast and deucravacitinib), an aryl hydrocarbon receptor (AHR) agonist, light therapy and alternative therapy.
2. Lichen planus can be treated with medications such as corticosteroids, antihistamines, phototherapy, immunosuppressants, retinoids (vitamin A derivatives), practicing good oral hygiene, minimizing trauma to the mouth, and replacing dental fillings.

The following table summarizes the difference between psoriasis and lichen planus.

Summary – Psoriasis vs Lichen Planus

Psoriasis and lichen planus are two different chronic skin conditions that cause itchy rashes on the skin. Both these conditions may have similar symptoms such as skin rashes, inflammation, nails falling off, etc. But psoriasis is an autoimmune condition while lichen planus is not an autoimmune condition. Moreover, psoriasis is scaly and does not affect the mouth region while lichen planus is non-scaly and does affect the inside of the mouth. In addition, Lichen planus tends to cause more intense itchiness than psoriasis. This is the summary of the difference between psoriasis and lichen planus.

 FAQ: Psoriasis and Lichen Planus

1. What is the main cause of psoriasis?

• Psoriasis is an autoimmune condition. It is thought to be an immune system problem where infection-fighting cells attack healthy skin cells by mistake. Researchers believe that both genetics and environmental factors play a role.

2. How can psoriasis be cured?

• There is no cure for psoriasis. Psoriasis flare-ups and spreading can be treated with prescription creams, moisturizers, or medications. Maintaining overall health can also help improve symptoms.

3. What is the main cause of lichen planus?

• The exact cause of lichen planus is usually not known, although possible risk factors include hepatitis C infection, certain medicines, including some drugs used to treat high blood pressure, diabetes, heart disease, malaria, and reactions to metal fillings in the teeth.

4. Which foods trigger lichen planus?

• It is a good idea to avoid spicy or acidic foods or drinks that may cause further irritation. Food that can trigger lichen planus include hot peppers, salsas, citrus fruits, tomatoes, and alcohol.

5. Which is the best treatment for lichen planus?

• Corticosteroid pills or shots can help when lichen planus lasts a long time or a patient has many painful bumps or sores. PUVA light therapy and retinoic acid can also help clear the skin.

Reference:

1. “PSORIASIS: Pictures, Symptoms, Causes, Diagnosis, Treatment.” WebMD.
2. “Lichen Planus: What It Is, Causes, Types & Treatments.” Cleveland Clinic.

Image Courtesy:

1. “Psoriasis on elbow” By Haley Otman – Haley Otman (2019-10-29). 5 Things a Dermatologist Wants You to Know About Psoriasis” (CC BY 3.0) via Commons Wikimedia
2. “Lichen planusWickham‘” By James, Candice, Mai – http://bohone09.wikispaces.com/Group+1 (CC BY-SA 3.0) via Commons Wikimedia

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