What is Lichen Planus

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Lichen planus consists of a group of T-cell mediated autoimmune diseases that include inflammatory skin conditions. These attack the skin and/or mucosal surfaces to varying degrees. The condition is relatively common, with approximately one in 100 people affected worldwide. The age group most representative of lichen planus patients is adults over the age of 40. One of the most common signs of lichen planus of the oral cavity is the appearance of lacy white streaks on the tongue.

Types of Lichen Planus: Oral, Vulval, Erosive, Nail, and Planopilaris

Several types of lichen planus are recognized. Oral lichen planus is the most common variation, affecting about half of the people with the condition. Some other types of lichen planus include:

Cutaneous (Classic) Lichen Planus: Shiny, flat-topped, firm papules and polygonal plaques with fine, white lines of pinpoint to over 1cm in size; may be intensely itchy; can appear anywhere on the body

Oral Lichen Planus: Commonly affects the insides of the cheeks and sides of the tongue (gums and lips may be affected); painless pattern of fern-like or lacy white streaks; accompanied by erosions and ulcers

Vulval Lichen Planus: Located on labia majora and minora, as well as vaginal introitus; lacy or fern-like white streaked pattern with painful ulcers and erosions possible; scarring, adhesions, bleeding on contact, introital stenosis, and resorption of labia minora may prevent intercourse

Penile Lichen Planus: Papules located in a ring around the glans; possible (but rare) white streaks and erosive ulcers

Erosive Lichen Planus: In some cases, the lacrimal glands, external ear canal, eyelids, esophagus, bladder, anus, and larynx may be affected

Lichen Planopilaris: Appears as follicular papules that look like tiny, red, spiny bumps on the scalp; may appear elsewhere; blisters may be present; hair follicle destruction leads to permanent baldness; frontal fibrosing alopecia and Pseudopelade of Brocq are variants

Nail Lichen Planus: Thins out the nail; grooves and ridges may appear; one or all finger and toe nails may be affected; nails may also thicken, darken, shed, stop growing, or disappear; total destruction of the cuticle may occur

Lichen Planus Pigmentosus: Grayish-brown discoloration of the face, neck, lips, armpits, trunk, and/or limbs; commonly (but not always) provoked by solar exposure

Lichenoid Drug Eruption: Exposure to medications or other substances causes a lichen planus-like rash; common culprits include: gold, quinine, hydroxychloroquine, captopril, and thiazide diuretics

Effective Lichen Planus Treatment

Erosive lichen planus (particularly amongst carriers of human papillomavirus) may develop into squamous cell carcinoma. Due to the widely varying causes of lichen planus, treatments vary significantly (from no recommended treatment to topical creams and injections, to highly effective, long-term, systemic treatments.) Contact Allegheny Advanced Dermatology Center to schedule an appointment. Call: (814) 944-7109.