Lichen planus

Lichen planus is an abnormal skin condition in which there is an itchy, swollen rash on the skin or in the mouth. 

Lichen planus can appear on any area of the skin. The most common areas are the inner wrists, the forearms and the ankles. 

Lichen planus may also affect the scalp, the nails or the inside of the mouth. On the scalp, lichen planus may cause hair loss.

Lichen planus of the nails can cause brittle or split nails. In the mouth, it looks like lacy white patches on the inside of the cheeks or on the tongue.

Sometimes lichen planus affects areas of skin where you had a cut or burn.

Oral lichen planus -symptoms

• Painless white streaks in a lacy or fern-like pattern
• Painful and persistent ulcers (erosive lichen planus)
• Diffuse redness and peeling of the gums (desquamative gingivitis)

Vulval lichen planus –symptoms-

• As in the mouth, lichen planus may cause painless white streaks.

Vaginal lichen planus-symptoms-

• Sometimes lichen planus affects deeper within the vagina where it causes desquamative vaginitis. The surface cells in the vagina peel off and cause a mucky discharge. The eroded vagina may bleed easily on contact.

Penile lichen planus-symptoms-

• Classical papules are the most common form of lichen planus on the penis and mostly occur in a ring around the glans (tip of the penis). White streaks and erosive lichen planus are much less common on the penis.

Lichen planus in nails-symptoms-

• Lichen planus affects one or more nails, sometimes without involving the skin surface – if all nails are abnormal and nowhere else is affected it is called twenty nail dystrophy. The nail plate tends to thin and may become grooved and ridged. The nail may darken, thicken up or lift off the nail bed (onycholysis). Sometimes the cuticle is destroyed and forms a scar (Pterygium). The nails may shed, stop growing altogether and rarely, completely disappear.

Actinic lichen planus-symptoms-

• Actinic lichen planus only affects sun exposed sites such as face, neck and the backs of the hands.

Scalp lichen planus- symptoms-

• LP can affect hairy areas such as the scalp in rare cases. This is called lichen planopilaris, and can lead to redness, irritation, and in some cases, permanent hair loss.

1. Usually located on the inner wrist, legs, torso, or genitals
2. Itching
3. Symmetrical-comes both sides
4. Single lesion or clusters of lesions, often at sites of skin trauma
5. Papules clustered into a large, flat-topped lesion.Lesions have distinct, sharp borders
6. Possibly covered with fine white streaks or scratch marks called Wick ham’s striae
7. Shiny or scaly appearance
8. Dark colored — reddish-purple in skin or grey-white in mouth.
9. Possibility of developing blisters or ulcers

1. Tender or painful in mild cases may have no discomfort.
2. Located on the sides of the tongue or the inside of the cheek
3. Occasionally located on the gums
4. Poorly defined area of blue-white spots or “pimples”
5. Lines of lesions that form a lacy-looking network
6. Gradual increase in size of the affected area
7. Lesions occasionally form painful ulcers

• Dry mout
• Hair loss
• Metal taste in the mouth
• Ridges in the nails -nail abnormalities