World Journal of Pharmaceutical Research

Favade et al. SJIF Impact

World Journal of Pharmaceutical Factor 7.523
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Volume 6, Issue 4, 442-448. Review Article ISSN 2277– 7105

LICHEN PLANUS: AN ACUMEN THROUGH AYURVEDA

Aditya Shahaji Favade*1 and Sadhana Prithviraj Chavan2

1
B.A.M.S, PGDMC, D. Dermatology (Ay).
2
M.D Scholar, Dept. of Kayachikitsa, College of Ayurved, Bharati Vidyapeeth Deemed
University, Katraj-Dhankawadi, 411046, Pune, Maharashtra, India.

ABSTRACT
Article Received on
27 Jan. 2017, Twak (skin) is one of the 5 gyanendriyas (sensory organs) according to
Revised on 16 Feb. 2017, Ayurveda, which is responsible for sparshagyan (touch sensation). In
Accepted on 09 March 2017
Ayurveda all the skin diseases have been narrated under kushtaroga.
DOI: 10.20959/wjpr20174-8014
Kustha’s are additionally classified into mahakushta and
kshudrakushta. Lichen planus can be correlated with charmakushta
*Corresponding Author
due to their more or less similar clinical appearance. According to
Dr. Aditya Shahaji Favade
B.A.M.S, PGDMC, D. Charaka, charmakushta is vata-kapha predominant which is
Dermatology (Ay). mentioned under kshudrakushta. Charmakushta is also mentioned in
Ashtang Sangraha and Ashtang Hridaya. Lichen planus is rare skin
disease affecting about less than 1% of world’s population but should not be ignored. It is an
inflammatory, papulosquamous disorder affecting either or all of the skin, mucous
membranes, hair and the nail which is clinically characterized by erythematous-to-violaceous,
flat topped, polygonal papules distributed mainly on the flexor aspects of the extremities,
associated with intense pruritus. Beholding into the management in modern medicines,
steroids have been the drugs of choice. Their hazards, side effects are well known. There is a
need to treat the patient with effectual and safe treatment based on the dosha dominance.
Lichen planus is a crucial entity to manage. Thus, it would be a great vantage if this disease
could be managed through traditional system of medicine like Ayurveda, which would prove
to be a good accustomed treatment and prevent the development of complications. This
article aims at understanding of lichen planus through a modern and Ayurvedic perspective
and critically analyzes the treatment options in Ayurveda and recent researches.

KEYWORDS: Lichen planus, charmakushta, medicinal herbs, Ayurvedic chikitsa, pathya-

apathya.

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INTRODUCTION
Lichen planus is an inflammatory papulosqamous disorder affecting either all of the skin,
mucous membranes, hair and nail. The name lichen planus has been derived from Greek
word ‘liechen’ (tree moss) and Latin word ‘planus’ (flat).[1] Lichen planus can be correlated
with charmakushta due to their more or less similar clinical appearance. According to
Charaka, charmakushta is vata-kapha predominant which is mentioned under kshudrakushta.
In charmakustha, the skin over the patch becomes thick like the skin of the elephant.[2]

Epidemiology
Prevalence of Lichen planus is less than 1% worldwide.[3] An incidence of 0.38% has been
reported from India.[4]

Etiology and Pathogenesis (Modern medicine)

Infectious agents, drugs and chemicals are known to be involved in the pathogenesis of
Lichen Planus.[1,5] Dental amalgam materials are known to cause oral lichenoid reactions.[6]
Activation of cell-mediated immune response destined towards keratinocyte apoptosis is the
prime event. The process involves,

LP-specific antigen recognition

Cytotoxic lymphocyte activation

Keratinocyte apoptosis

Etiology and Pathogenesis (Ayurveda)[7]

1. Intake of mutually contradictory food and drinks which are liquid, unctuous and heavy.
2. Suppression of the urge for vomiting and other natural urges.
3. Performance of physical exercise in excessive heat and after taking very heavy meal.
4. Transgression of the prescribed order with reference to heat and cold as well as fasting
and intake of food.
5. Use of cold water immediately after exposure to scorching sun, exertion or exposure to
frightening situation.
6. Intake of uncooked food and intake of food before the previous meal is digested.
7. Transgression of the procedure of panchakarma.

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8. Excessive intake of food preparations of freshly harvested grains, curd, fish, salt and sour
substances.
9. Excessive intake of masa (Phaseolus mungo), mulaka (radish), tila (seasame seeds), milk
and jaggery.
10. Performance of sexual act in the state of indigestion.
11. Sleep during day time.

Three vitiated doshas (vata, pitta, kapha) in turn vitiate the tvak (skin), rakta (blood), mamsa
(muscular tissue) and ambu (lymph).These are taken together, constitute the seven fold
pathogenic substance of kushta. The seven and eleven varities of kushta are caused by all of
them. Kushtas are never caused by the vitiation of only one of the above mentioned
pathogenic substance, i.e. all of them are necessarily involved in the causation of this disease.

Classification and Clinical features

Clinical features
Classical lesions of cutaneous Lichen planus has been described erythematous-to-violaceous,
flat topped, polygonal papules distributed mainly on flexor aspects of extremities, associated
with intense pruritus. The oral cavity, genitals, nails and scalp may also be involved.[8]

Classification
A. Linear morphology[1, 5]
1. Hypertrophic
2. Atrophic
3. Guttate (eruptive)
4. Annular
5. Linear
6. Vesiculobullous
7. Follicular
8. Ulcerative
9. Lichen planus pigmentosus

B. Sites of involvement
1. Mucosal (oral, genital)
2. Palmoplantar
3. Nail

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4. Scalp
5. Inverse

C. Special forms
1. Actinic
2. Lichen planus pemphigoides

Diagnosis
Histopathological confirmation is necessary where clinical picture is not so classical, and in
some clinical variants.[8]

Treatment[8]
Different treatment modalities are in use for Lichen Planus.

A. Topical Therapy
a) Corticosteriods (Potent corticosteroid oinments)
b) Topical Calineurin Inhibitors

B. Systemic Therapy
a) Systemic Corticosteroids
b) Systemic Retinoids

What Ayurveda says?[9]

1. The patient suffering from kushta dominated by vayu should first be administered ghee
internally.
2. The patient suffering from kushta dominated by kaphas should first be administered
emetic therapy.

So preferably we can do snehapana and vamana in charmakushta as it is vata and kapha

dominated.

MATERIALS AND METHODS

Materials related to concept of Lichen Planus, and other relevant topics have been collected.
For Ayurvedic and modern concepts of Lichen Planus reference have been taken from
textbooks, various websites, electronic media and articles.

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1. Mustadi Churna[10]
This is an infallible remedy for the treatment of kustha.

2. Triphaladi Churna[11]
This is an excellent for the cure of supti (numbness).

3. Kanakabindvarista[12]
Intake of this is useful in kushta’s caused by tridosha. However, use of decoction of
Kritamala (in the place of Khadira) in this will make it separately useful in curing kaphaja
kushta.

4. Triphaladi Kashaya[13]
This cures kushta caused by kapha and pitta.
Medicated ghee prepared by boiling with the decoction of the mentioned drugs in triphaladi
kashaya cures vata type of kushta.

5. Shveta Karavirapallayadya Taila [14]

External application of this taila eradicates kustha and kandu (itching).

6. Tikteshvadi Taila [15]

External application of this taila cures kandu (itching).

7. Mahatiktaka ghrita [16]

Administration of this ghrita cures kushta and kandu (itching).

8. Vajrak taila[17]
Application of this taila cures kushta but especially kapha-vata type of kushta.

This ghee is administered in appropriate time and suitable time in accordance with the
strength of the patient.

Pathya-Apathya[18]
The patient suffering from kustha should take following types of diet:
1. Laghu ahara – Light and wholesome food
2. Tikta shaka – Vegetables (leafy) having bitter taste
3. Food preparations and medicated ghee prepared by boiling with Bhallalaka, Triphala and
Nimba

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4. Old (not freshly harvested) cereals and

5. Jangala Mamsa and preparations of Mudga (green gram) mixed with Patola.
Intake of heavy and sour food, milk, curd, fish, Guda (Jaggery) and Tila are prohibited
for patients of kustha

What’s new?
1. Tulsi (Ocimum sanctum) have the unique property of acting on the skin and blood tissue
and also bring about the desired immunomodulators and it one of the treatment options in
Ayurveda for treating Lichen Planus.[19]
2. A pilot study was conducted in the Department of Oral and Maxillofacial surgery,
KGMU, Lucknow. The 10 patients were included in the study, they were clinically
diagnosed and histopathologically confirmed as patients of oral lichen planus. The extract
of turmeric in the ointment form was made and used for local application twice/day for a
period of 3 months.[20]

CONCLUSION
Lichen planus is a crucial entity to manage. As the medications for Lichen Planus according
to modern medicine may cause adverse effects in the body may lead to anxiety in the patient.
The herbs mentioned in this article can be effectual and safe treatment based on the dosha
dominance. Further researches in Ayurveda will help patient to stay away from adverse
effects and complications. Thus, it would be a great vantage if this disease could be managed
through Ayurveda, which would prevent the development of complications

REFERENCES
1. Daoud MS, Pittelkow MR. Lichen Planus. In: Irwin MF, Eisen AZ, Wolff K, Austen KF,
Goldsmith LA, Katz SI, editors. Fitzpatrick’s Dermatology in general medicine. 6th
edition. New York: MacGraw-Hill; 2003; 463-77.
2. Prof. Ravi Dutt Tripathi, Acharya Vidyadhar Shukla, Charak Samhita, Chikitsa Sthana,
Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/21, pp.- 184
3. Boyd AS, Neldner KH. Lichen planus. J Am Acad Dermatol. 1991; 25: 593-619.
4. Bhattacharya M, Kaur I, Kumar B. Lichen planus: a clinical and epidemiological study. J
Dermatol. 2000; 27: 576-82.
5. Breathnach SM, Black MM. Lichen planus and lichenoid disorders. In: Burns T,
Breathnach S, Cox N, et al, editors. Rook’s textbook of dermatology. 7th edn. Oxford:
Blackwell Science: 2004; 42: 1-32.

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6. Laine J, KAlimo K, Forssell H, Happonen R-P. Resolution of oral lichenoid lesions after
replacement of amalgam restorations in patients allergic to mercury compounds. Br J
Dermatol. 1992; 126: 10-15.
7. Prof. Ravi Dutt Tripathi, Acharya Vidyadhar Shukla, Charak Samhita, Chikitsa Sthana,
Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/4-10, pp.- 181-182.
8. IADVL Textbook of Dermatology by R.G. Valia Volume: 1 Third Edition.
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Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/39, pp.- 186.
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Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/65-67, pp.- 190.
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Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/68, pp.- 190.
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Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/77-79, pp.- 191.
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Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/100, pp.- 194.
14. Prof. Ravi Dutt Tripathi, Acharya Vidyadhar Shukla, Charak Samhita, Chikitsa Sthana,
Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/105-106, pp.- 194.
15. Prof. Ravi Dutt Tripathi, Acharya Vidyadhar Shukla, Charak Samhita, Chikitsa Sthana,
Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/108-110, pp.- 195.
16. Prof. Ravi Dutt Tripathi, Acharya Vidyadhar Shukla, Charak Samhita, Chikitsa Sthana,
Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/146-148, pp.- 199.
17. Dr. Bramhanand Tripathi, Ashtang Hridayam, Chikitsa Sthana, Chaukhamba Sanskrit
Pratishthan, Delhi, ed-2012, Shloka 19/79-80, pp.-793.
18. Prof. Ravi Dutt Tripathi, Acharya Vidyadhar Shukla, Charak Samhita, Chikitsa Sthana,
Chaukhambha Sanskrit Pratishthan, Delhi, ed-2010, Shloka-7/82-83, pp.- 192.
19. Abdulmubeen Mundewadi. Ayurvedic Herbal Treatment. Available at
http://www.EzineArticles.com/?expert=Abdulmubeen_Mundewadi(LP).
20. Vibha Singh, Mahesh Pal, Shalini Gupta, S. K. Tiwari, Laxman Malkunje, and Somdipto
Das. Turmeric - A new treatment option for lichen planus: A pilot study. [cited Jul 2013].
Available at http://www.ncbi.nlm.nih.gov/pubmed/24665176.

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