Carl R. Darnall Army Medical Center - Health Library

Lichen Planus

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.

RESOURCES:

American Academy of Dermatology
http://www.aad.org

DermNet NZ
http://www.dermnetnz.org

CANADIAN RESOURCES:

Canadian Dermatology Association
http://www.dermatology.ca

Dermatologists
http://dermatologists.ca

REFERENCES:

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 December 15, 2017.

Lichen planus. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=LichenPlanus. Accessed December 15, 2017.

Lichen planus. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116470/Lichen-planus. Updated April 7, 2016. Accessed December 15, 2017.

Lichen planus. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/dermatologic-disorders/psoriasis-and-scaling-diseases/lichen-planus. Updated January 2017. Accessed December 15, 2017.

Last reviewed December 2017 by EBSCO Medical Review Board Michael Woods, MD,FAAP  Last Updated: 12/20/2014