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 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.

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Comment from: SF Judi, 65-74 Female (Patient) Published: April 14

I was in my thirties and was visiting a friend who put me put me up for a night. I awoke in the middle of night screaming in pain and threw off my crocheted blanket. My right foot by the ankle felt like something big bit me! My foot swelled up big time. I thereafter had the itching and breakout. I had several dermatologists after that do a biopsy on the bite area, only to find nothing! When I got to retire, my first dermatologist told me I had lichen planus and showed me pictures in a medical manual. Since then, I am treated with a cortisone type cream when itching occurs (age 69). I always felt it was a spider bite that started it!

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Comment from: kanutten, 35-44 Female (Patient) Published: July 15

I was diagnosed with lichen planus by my obstetrician/gynecologist, first visually. Then she took a biopsy just to confirm, and 3 weeks later it was confirmed. As she also suspected that I would have this in my mouth, I also went to a dental specialist who diagnosed it in my mouth visually.

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