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General Medicine

Lichen Planus

Dongsheng Jiang, MS, MD and Juan Qiu, PhD, MD Reviewed 04/2024
 


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.

  • Dermoscopy: Most common findings are polymorphic pearly white structures, radial capillaries, and...

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
Rotaru D, Chisnoiu R, Picos AM, et al. Treatment trends in oral lichen planus and oral lichenoid lesions (Review). Exp Ther Med. 2020;20(6):198.
2
Thandar Y, Maharajh R, Haffejee F, et al. T...

CODES

ICD10

  • L43.9 Lichen planus, unspecified

  • L43.0 Hypertrophic lichen planus

  • L43.1 Bullous lichen planus

  • L43.8 Other lichen planus

SNOMED

  • 4776004 Lichen planus (disorder)

  • 68266006 Hypertrophic lichen planus...

CLINICAL PEARLS

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

  • Serial oral or genital exams are indicated for ero...

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Related Images
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Lichen planus. The Köbner phenomenon (isomorphic response) results from scratching. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.

 

Lichen planus. The Köbner phenomenon (isomorphic response) results from scratching. From Goodheart HP. Goodheart's Photoguide to Common Ski...

Lichen planus. Oral lesions, with a white, lacy, reticulated, pattern on the buccal mucosa. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.

 

Lichen planus. Oral lesions, with a white, lacy, reticulated, pattern on the buccal mucosa. From Goodheart HP. Goodheart's Photoguide to Co...

Lichen planus. Typical flat-topped papules are noted on the glans and the distal shaft of this patient's penis (compare to psoriasis of penis in Figure 4.24). From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.

 

Lichen planus. Typical flat-topped papules are noted on the glans and the distal shaft of this patient's penis (compare to psoriasis of pen...

Lichen planus, hypertrophic. Darkly pigmented hypertrophic lesions are present on the pretibial shaft. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.

 

Lichen planus, hypertrophic. Darkly pigmented hypertrophic lesions are present on the pretibial shaft. From Goodheart HP. Goodheart's Photo...

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