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Lichen Planus

Reviewed 06/2018
 


BASICS

Lichen planus (LP) is an idiopathic eruption with characteristic shiny, flat-topped (Latin: planus, “flat”) purple (violaceous) papules and plaques on the skin, often accompanied by characteris...

DIAGNOSIS

LP is most commonly diagnosed by its appearance despite its range of clinical presentations. A skin biopsy should be performed if the diagnosis is in doubt. 

HISTORY

A minority of patients hav...

TREATMENT

Although LP can resolve spontaneously, treatment is usually requested by patients who may be severely symptomatic or troubled by its cosmetic appearance. 

GENERAL MEASURES

  • Goal is to relieve i...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

Serial oral examinations for erosive/ulcerative lesions 

PATIENT EDUCATION

  • Oral, erosive, or ulcerative LP: annual follow-up to screen for maligna...

REFERENCES

1
Shengyuan L, Songpo Y, Wen W, et al. Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis. Arch Dermatol.  2009;145(9):1040–1047. [View Abstrac...

ADDITIONAL READING

  • Fazel N. Cutaneous lichen planus: a systematic review of treatments. J Dermatolog Treat.  2015;26(3):280–283. [View Abstract on OvidMedline]

  • Kolios AG, Marques Maggio E, Gubler...

CODES

ICD10

  • L43.9 Lichen planus, unspecified

  • L43.0 Hypertrophic lichen planus

  • L43.1 Bullous lichen planus

  • L43.8 Other lichen planus

ICD9

697.0 Lichen planus 

SNOMED

  • 4776004 Lichen planus (disorder)

  • 68266006 Hy...

CLINICAL PEARLS

  • Remember the 7 P’s of LP: purple, planar, polygonal, polymorphic, pruritic (not always), papules that heal with postinflammatory hyperpigmentation.

  • Serial oral or genital exams are indi...

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