Lichen Planus: Santa Clara Medical Center, Department of Dermatology #472
Lichen Planus: Santa Clara Medical Center, Department of Dermatology #472
Lichen Planus: Santa Clara Medical Center, Department of Dermatology #472
What is Lichen Planus (LP)? Lichen planus is an uncommon skin complaint whose cause is
unknown. It can affect the skin, the mouth, or both. About one percent of the general population
may be affected.
The skin rash is characterized by shiny flat-topped pink to purple papules (bumps) on the skin
varying from pinpoint size to larger than a centimeter. They may be scaly and often are crossed by
fine white lines called Wickham's striae. They may be close together or widespread, or grouped in
lines or rings. They are often very itchy. In the mouth, white lines may also be seen and there may
be sores along the cheeks, gums or tongue. Onset may be slow, taking months to reach its peak. It
usually clears with 18-24 months, but may persist for years
What causes Lichen Planus? Lichen Planus is thought to be due to an abnormal immune
reaction. It may be associated with a viral infection and your doctor may test you for this.
However, it is not considered an infectious condition and cannot be spread to others by contact. It
is not considered a cancerous or precancerous condition.
A similar condition, called a lichenoid drug eruption, is sometimes caused by medications such as
gold given for arthritis, antimalarial tablets and certain high blood pressure medications. Lichenoid
drug eruptions clear up slowly when the responsible medication is withdrawn.
As the lichen planus papules clear they are often replaced by areas of brown discoloration,
especially in darker skinned people. New lesions may appear while others are clearing. Some may
become thick and scaly.
Lichen planus may affect any area, but is most often seen on the wrists, lower back, and ankles.
The female genital area may be involved with a similar condition (erosive vulvitis) which may be
very itchy and painful. Lichen Planus involving the scalp (lichen planopilaris) is rare and may lead
to permanent hairloss. Uncommonly, nail changes can occur including minor pits or grooves, but
occasionally shedding or destruction of the full nail occurs.
How is Lichen Planus treated? There is no known cure for lichen planus. Treatment is not
always necessary as it may resolve on its own. Treatment may help to relieve itch and improve
the appearance.