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. There it resembles a white spider web. It may ulcerate. Rarely, it can also become cancerous. The scalp and fingernails can also be affected. It may become wart-like in thickness. Lichen planus may continue on and off for months or years. Scratching makes this condition worse.
Not much is known about the cause. It is possibly an immunologic reaction due to genetic factors. It may be brought on by certain medications or diseases.
Lichen planus is more likely to occur in the presence of:
The condition is more common in females. It is also more common in those aged 30-60 years. Lichen planus is rare in children and the elderly.
Lichen planus may cause:
Your doctor will ask 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.
Talk with your doctor about the best plan for you. Treatment options include the following:
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.
Canadian Dermatology Association
Gorouhi F, Solhpour A, et al. Randomized trial of pimecrolimus cream versus triamcinolone acetonide paste in the treatment of oral lichen planus. J Am Acad Dermatol. 200757(5):806-813.
Lichen planus. American Academy of Dermatology website. Available at: https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/i---l/lichen-planus. Accessed November 6, 2015.
Lichen planus. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=LichenPlanus. Accessed November 6, 2015.
Lichen planus. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116470/Lichen-planus. Updated April 7, 2016. Accessed September 29, 2016.
Lichen planus. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/dermatologic-disorders/psoriasis-and-scaling-diseases/lichen-planus. Updated November 2014. Accessed November 6, 2015.
Turan H, Baskan EB, et al. Methotrexate for the treatment of generalized lichen planus. J Am Acad Dermatol. 2009;60(1):164-166.
Wackernagel A, Legat FJ, et al. Psoralen plus UVA vs. UVB-311 nm for the treatment of lichen planus. Photodermatol Photoimmunol Photomed. 2007;23(1):15-19.
Last reviewed November 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.