Lichen Planus - Diagnosis

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What types of tests or exams led to a diagnosis of lichen planus?

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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 to 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 seems to be a few patients in whom ulcerative lichen planus precedes the development of oral cancer.

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Comment from: Carolyn, 55-64 Female (Patient) Published: April 22

I have suffered with lichen planus now for more than three years. It first started with red gums and it was very difficult to eat. Then, I broke out with a rash on my legs. Later, it got really bad in my mouth and on my lips. I have had ear canal problems that have been very serious at times. I have terrible sinus problems and a terrible time with dry eyes and pus on the eye lids, especially at night. My throat swells to where I can barely swallow a small pill, and when I wake, my esophagus feels like there's a tight rubber band on it. It gets little better as the day goes on, but sometimes everything I try to swallow hurts when it goes down. I am on Pacquenil and small dose of prednisone. When it started going into my eye I was put on a high dose of prednisone and felt like a new person. But, it was too risky, so was cut to the minimal, which barely works. I was sent to a university medical center, where they came up with three plans. One was Quinacrine, but I was allergic to it. The second was cyclosporine, which tasted nasty. I don't even know what the third plan is. I have a few somewhat good days but most days are really bad. The doctors said I'm in the top 10 worst cases they have seen. I hope I wake one morning and it is totally gone. I just keep telling myself there is worse out there.

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Comment from: vatrekker, 65-74 Male (Patient) Published: November 20

A punch and slice biopsy confirmed I have lichen planus chronicus. The dermatologist advised me it is an immune system skin disease. I have been using clobetasol for a year but does not seem to help. The doctor advised me that oral medication is the next step.

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