Lichen planus

Lichen planus

• itchy, papular rash most common on the palms, soles, genitalia and flexor surfaces of arms
• rash often polygonal in shape, with a 'white-lines' pattern on the surface (Wickham's striae)
• Koebner phenomenon may be seen (new skin lesions appearing at the site of trauma)
• oral involvement in around 50% of patients: typically a white-lace pattern on the buccal mucosa
  Oral lichen planus typically presents with buccal white-lace pattern lesions and ulcers
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  Importance: 40
• nails: thinning of nail plate, longitudinal ridging

Lichen planus - classic polygonal papules on extensor surfaces of the forearms and legs

Lichen planus - pruritic eruption on the shins

Lichen planus

Lichen planus - oral involvement: white-lace pattern on the buccal mucosa

Lichen planus

• gold
• quinine
• thiazides

• potent topical steroids are the mainstay of treatment
  Potent topical steroids are the first-line treatment for lichen planus
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  Importance: 89
• benzydamine mouthwash or spray is recommended for oral lichen planus
  benzydamine mouthwash or spray is recommended for oral lichen planus
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• extensive lichen planus may require oral steroids or immunosuppression