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Patient education: Lichen planus (The Basics)

Patient education: Lichen planus (The Basics)

What is lichen planus? — Lichen planus is a condition that can cause many different types of spots on the skin or mucous membranes. The "mucous membranes" are the pink, moist skin that lines the inside of the mouth, vagina, and other organs.

In some cases, lichen planus causes red, purple, or dark-colored spots to form on the skin. These spots often itch. Lichen planus can also cause white spots or painful sores, especially on the mucous membranes.

In most cases, doctors do not know what causes lichen planus.

What are the symptoms of lichen planus? — Lichen planus causes different symptoms, depending on which body part is affected.

Skin – On the skin, lichen planus usually causes shiny, flat, red, purple, or dark-colored spots (picture 1 and picture 2). These spots tend to form on the wrists, arms, or legs, but might also appear on other areas. The spots are often very itchy. As the spots heal, they can turn darker.

Nails – On the nails, lichen planus can cause lines or ridges to form.

Mucous membranes – This is the pink, moist skin that lines the inside of the mouth, vagina, and other organs. In these places, lichen planus can cause redness, painful sores, or patterns that look like white lace (picture 3). When lichen planus affects the mouth, it can make it hard to eat.

Should I see a doctor or nurse? — Yes, if you have symptoms like those listed above, see your doctor or nurse.

Your doctor or nurse will probably be able to tell if you have lichen planus by learning about your symptoms and doing an exam. Your doctor or nurse might take a small sample of skin to send to the lab. This is called a skin "biopsy."

How is lichen planus treated? — Treatment depends on which body part is affected and how bad the symptoms are. In general, treatment can include:

Steroid medicines that come in ointments, creams, or gels – These steroid medicines reduce inflammation and help the skin heal. Examples include fluocinonide or clobetasol.

Medicines called calcineurin inhibitors, such as pimecrolimus (brand name: Elidel) and tacrolimus (brand name: Protopic)

Medicines that numb the skin and help with pain, especially for people who have sores on their mouth or genitals

Pills that help to reduce inflammation and help the skin heal

A special type of light treatment called phototherapy

Some people need to try more than 1 medicine before they find the medicine that works best for them.

Is there anything I can do on my own to feel better? — Yes. You should:

Take good care of your skin. Wash and dry your skin gently when you take a shower or bath. Try not to scratch itchy skin because that can increase the chance of infection. Scratching can also make lichen planus worse.

If you have lichen planus in your mouth, take good care of your teeth and gums. Brush your teeth twice a day with a soft brush, and floss every day. Not taking good care of your mouth could make lichen planus worse and might cause other problems from unhealthy teeth and gums.

More on this topic

Patient education: Lichen sclerosus (The Basics)
Patient education: Vulvar itching (The Basics)
Patient education: Vulvar pain (The Basics)
Patient education: Dyspareunia (painful sex) (The Basics)

Patient education: Vulvar lichen sclerosus (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 02, 2023.
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