Lichen Planus

Chronic inflammatory disease affecting skin

Skin Lesion Features

6P Plain topped Purple Polygonal Pruritic Papules Plaques

Nail Changes

• Thinning (m/c) • Pup tent sign • Dorsal Pterygium (m sp) • Tracheonychia

Oral Lesion

Reticular white Wickham striae; erosive/ulcerative lesions possible

Pathology

Saw-tooth appearance of rete ridges; band-like lymphocytic infiltrate; Civatte bodies

Classic Sites

Flexor wrists

Associated Infection

Hepatitis C

Variants

Hypertrophic (thick plaques)

Diagnosis

Clinical Biopsy for confirmation (atypical/severe cases)

Malignant Potential

Oral erosive lichen planus has low but present risk for malignant transformation

Management

Topical steroids first-line; oral steroids/immunosuppressants/calcineurin inhibitors if severe

Koebner Phenomenon

Lesion formation at sites of trauma

Drug-induced LP

Biopsy may show eosinophils

Differential Diagnosis

Psoriasis

Complications

Post-inflammatory hyperpigmentation