Pronounced: LIE-ken PLAN-us
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.
Section of Skin with Lichen Planus
Not much is known about the cause. It is one of many skin diseases brought on by certain medications or diseases.
Lichen planus is more likely to occur in the presence of:
- Hepatitis C
- Systemic lupus]]> erythematosus
- Certain prescription medications
- Graft vs. host disease
The condition is more common in females. It is also more common and in those 30 to 60 years old. Lichen planus is rare in children and the elderly.
Many skin and mucus membrane conditions appear similar. Only your doctor can tell them apart. If you have anything resembling lichen planus, do not assume that is the condition. Skin conditions may be isolated, or they may be signs of a more serious internal disease. See your doctor to be sure.
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
- Milky-white, spider web-like patches in your mouth or vagina
Your doctor will ask about your symptoms, medications, and medical history. A physical exam will be done. 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 or oral antihistamines to relieve itching
- Other topical anti-itching products (pramoxine, menthol, eucalyptus oil)
- Soothing soaks (oatmeal, Burows solution 1:40)
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.
- Retinoids or immunomodulating medications may be useful, particularly for lesions in the mouth
- Ultraviolet light combined with oral medication has also been effective in widespread or resistant cases
Canadian Dermatology Association
Beers MH, Berkow R. The Merck Manual. 17th ed. West Point, PA: Merck & Co; 1999.
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Lichen planus. American Academy of Dermatology website. Available at: http://www.aad.org/public/publications/pamphlets/common_lichen.html . Accessed January 24, 2008.
Lichen planus. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/skin/dermatologic_diseases/lichen_planus.html . Accessed September 15, 2005.
Turan H, Baskan EB, Tunali S, Yazici S, Saricaoglu H. Methotrexate for the treatment of generalized lichen planus. J Am Acad Dermatol . 2009;60(1):164-6.
Wackernagel A, Legat FJ, Hofer A, Quehenberger F, Kerl H, Wolf P. Psoralen plus UVA vs. UVB-311 nm for the treatment of lichen planus. Photodermatol Photoimmunol Photomed . 2007 Feb;23(1):15-9.
Last reviewed January 2009 by ]]>Ross Zeltser, 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.
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