Lichen Planus

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What does lichen planus look like?

The appearance of lichen planus depends on whether the skin or the lining (mucous membranes) inside the mouth or vagina are affected:

  • Skin involvement: The usual skin involvement with lichen planus consists of flat-topped lilac or violet to brown spots a few millimeters in diameter on the skin. These spots tend to be located on the inner wrists, forearms, the lower legs just above the ankles, and the lower part of the back.
  • A variant of this disease is called hypertrophic lichen planus. This condition appears as thick, reddish-brown lesions that are covered with scales. These spots tend to be on the shins, but they can occur anywhere on the body. This is an especially itchy and persistent (chronic) variant of lichen planus.
  • Atrophic lichen planus produces slightly depressed lesions that otherwise resemble typical lichen planus.
  • Mucous membranes: Lichen planus of the mucous membranes of the mouth and genitalia is common. It appears as a white, lacy rash on the inside of the cheeks or the vagina and may not cause symptoms. The oral rash often occurs prior to any skin involvement. More troublesome, although rare, is erosive lichen planus, which can be quite sore and uncomfortable. This erosive form typically causes the patient to complain of the shallow and often quite painful, recurrent ulcers in the mouth or genitalia. Lichen planus of the female genitalia can involve the external vulvar mucosa and the internal vaginal mucosa. There is an association with cancer in these areas, so both the oral and vaginal tissues need to monitored by a medical professional.
  • Nail malformation may be produced by lichen planus.
  • Lichen planus may involve the scalp, producing a permanent, scarring type of balding.

What physicians diagnose and treat lichen planus?

Most dermatologists, gynecologists, and some oral surgeons diagnose and treat lichen planus.

Medically Reviewed by a Doctor on 5/11/2016

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