Definition: “Lichen planus is a chronic, inflammatory, autoimmune disease that affects the skin, oral mucosa, genital mucosa, scalp, and nails. ” AFP
Diagnosis
H&P
-Lichen planus is associated with Hepatitis C. So check CMP for mildly elevated transaminases.
-6Ps. Lichen planus lesions are described as planar (flat-topped), purple, polygonal, pruritic, papules, plaques.
-Lesions can be found on the wrist, ankle, back…
Treatment
1st-line: High potency topical corticosteroids.
Topical tacrolimus for vulvovaginal lichen planus.
Systemic steroids for widespread lichen planus involving the mouth, skin, and genitals.
Understanding the name.
Lichen Planus. Planus – planar (flat-topped). The dictionary defines lichen in medicine to be “Any of various skin diseases characterized by patchy eruptions of small, firm papules.”
http://www.medscape.com/viewarticle/446356_2
DDx of Lichen planus includes the following and more:
- Behçet’s syndrome
- Aphthous stomatitis
- Herpetic stomatitis
- HIV infection
References / Further Reading
N Engl J Med 2012;366(8):723-732. Lichen planus.
Am Fam Physician. 2011 Jul 1;84(1):53-60. Diagnosis and Treatment of Lichen Planus.