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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How is lichen planus diagnosed?

Usually, lichen planus is relatively straightforward to diagnose. Physicians can make the diagnosis in typical cases simply by looking at the rash. If necessary, a skin biopsy may be done to help confirm the diagnosis because, under the microscope, lichen planus is distinctive in appearance.

Because there are a number of other lichenoid eruptions that resemble lichen planus a biopsy confirmation is frequently necessary. Persistent oral or vaginal lichen planus, with spots that thicken and grow together, can sometimes be difficult to distinguish clinically from whitish precancerous plaques called leukoplakia. A biopsy can be helpful in this situation. There seem to be a few patients in whom ulcerative lichen planus precedes the development of oral cancer.

Are there home remedies for lichen planus?

Although there is little objective evidence of its benefits, green tea has been suggested as a treatment for lichen planus. It is likely to be a safe approach.

What is the treatment for lichen planus?

Most lichen planus is relatively mild. Affected individuals who do not have symptoms do not need treatment. Ultimately, there is no agreed-upon cure for this condition.

If the itch or appearance of the rash are unpleasant, topical corticosteroid creams or topical calcineurin inhibitors like tacrolimus or pimecrolimus may be of help. For localized, itchy, thick lesions, injections of corticosteroids directly into the plaque may helpful. Antihistamines may blunt the itch, particularly if it is only moderate. This effect is in part due to the sedative effect of antihistamines. For oral lesions, topical steroids (cortisone) in special oral preparations are available.

In more severe lichen planus, physicians may recommend oral medications or therapy with ultraviolet light. Oral medications may include a course of oral corticosteroids, such as prednisone or acitretin. Occasionally, other immunosuppressive agents may be employed. However, the itching may return after the drug has been discontinued. A low-dose oral corticosteroid every other morning may be also prescribed. For painful lesions within the mouth, special mouthwashes containing a painkiller (such as lidocaine) before meals may provide some relief. Any drug or chemical suspected of being the cause of the lichen planus should be discontinued.

Medically Reviewed by a Doctor on 5/11/2016

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