Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Lichen planus is a chronic skin condition. It causes itchy, flat, scaly patches on the wrists, legs, trunk, or genitals. It can also affect the inside of the mouth and vagina where it resembles a white spider web. The scalp and fingernails can also be affected. Lichen planus may continue on and off for months or years.

Section of Skin with Lichen Planus

Lichen Planus
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Causes

Not much is known about the cause. It may be due to genetic factors, certain medications, or diseases.

Risk Factors

The condition is more common in those aged 30-60 years.

Lichen planus is more likely to occur in the presence of:

Symptoms

Lichen planus may cause:

  • Itching, flat-topped purplish bumps or scaly patches—especially on the palm side of the wrists, the top of the foot and shins, the trunk, or the genitals
  • Hair loss
  • Abnormal appearance to the nails
  • Milky-white, spider web-like patches in the mouth or vagina, with or without burning or discomfort

Diagnosis

You will be asked about your symptoms, medications, and medical history. A physical exam will be done. Lichen planus usually can be diagnosed by the appearance of the rash. You may be referred to a dermatologist.

If the diagnosis is unclear, a skin biopsy may be done.

Treatment

Talk with your doctor about the best plan for you. Treatment options include the following:

Symptom Relief

Scratching makes this condition worse. This symptom can be eased with:

  • Topical or oral antihistamines
  • Other topical anti-itching products, such as menthol or eucalyptus oil
  • Soothing oatmeal baths

Steroid Medications

Topical steroids may be used to help decrease inflammation. Steroids may also be injected by a needle directly into a lesion. Oral or IV steroids are only used in severe cases.

Other Treatments

  • Retinoids or immunomodulating medications may be useful, particularly for lesions in the mouth or vagina
  • Ultraviolet light combined with oral medication has also been effective in widespread or resistant cases

Prevention

There are no current guidelines to prevent lichen planus. Avoid any medications that may have triggered it in the past.