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Rarely, blistering occurs in the lesions. Lichen planopilaris presents as tiny red spiny follicular papules and extending smooth areas on the scalp or less often, elsewhere on the body.

White streaks and erosive lichen planus may occur but are less common.Ĭlick here for images of genital lichen planus Other mucosal sitesĮrosive lichen planus uncommonly affects the lacrimal glands, eyelids, external ear canal, oesophagus, larynx, bladder, and anus.

Classical papules in a ring around the glans.

Overlap with vulval lichen sclerosus that most commonly affects women over 50 years of age.Ĭlick here for images of erosive vulval lichen planus Penile lichen planus.

Painful desquamative vaginitis, preventing intercourse and causing a mucky vaginal discharge the eroded vagina may bleed easily on contact.

Scarring, resulting in adhesions, resorption of labia minora and introital stenosis.

Painful and persistent erosions and ulcers ( erosive LP).

Painless white streaks in a lacy or fern-like pattern.

Lichen planus may affect the labia majora, labia minora, and vaginal introitus.

Plaques resolve after some months to leave greyish-brown post-inflammatory macules that can take a year or longer to fade.Ĭlick here for more images of oral lichen planus Vulval lichen planus.

New papules and plaques often have a purple or violet hue, except on palms and soles where they are yellowish-brown.

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Colour depends on the patient’s skin type.

Location can be anywhere, but most often front of the wrists, lower back, and ankles.

Distribution may be scattered, clustered, linear, annular, or actinic (sun-exposed sites such as face, neck, and backs of the hands).

Size ranges from pinpoint to larger than a centimetre.

Annular lichen planus describes the development of violaceous plaques with central clearing often involving penis, scrotum, and intertriginous areas.

Atrophic lichen planus is a rare annular variant with an atrophic centre.

Hypertrophic lichen planus can be a scaly and pruritic rash.

The plaques are crossed by fine white lines called Wickham striae.

Papules and polygonal plaques are shiny, flat-topped, and firm on palpation.

Symptoms can range from none (uncommon) to intense itch. The usual presentation of the disease is classical lichen planus. Lichen planus may cause a small number or many lesions on the skin and mucosal surfaces. What are the clinical features of lichen planus? Its association with other types of LP remains unexplored. Vitamin D deficiency may be associated with oral lichen planus.

Lichenoid inflammation is also notable in graft-versus- host disease. Drugs gold, quinine, quinidine, and others can cause a lichenoid rash.Contact allergy, such as to metal fillings in oral lichen planus (rare) and colour photographic developers.Systemic viral infection, such as hepatitis C (which might modify self- antigens on the surface of basal keratinocytes).Localised skin disease such as herpes zoster.Injury to the skin lichen planus often appears where the skin has been scratched or after surgery ( koebnerisation).Lichen planus is a T-cell mediated autoimmune disorder in which inflammatory cells attack an unknown protein within the skin and mucosal keratinocytes.Ĭontributing factors to lichen planus may include: It has no strong racial predilection.Īpproximately 10% of those affected have lichen planus of the nails while half of those affected have oral lichen planus, which is more common in women than in men. Lichen planus affects approximately 1% of the population worldwide, mostly affecting adults aged between 30 to 60 years. There are several clinical types:Ĭlick here for images of lichen planus Who gets lichen planus? Lichen planus (LP) is a chronic inflammatory condition affecting the skin and mucosal surfaces.