Lichen planus

Symptoms:

• itching in the location of a lesion
  • may be mild to severe

• skin lesion
  • usually located on the inner (flexor) aspects of the wrist, legs, torso, sacrum, or genitals
  • generalized
  • symmetric appearance
  • papule 2 to 4 cm size
  • papules coalesced into a plaque or large flat-topped lesion
  • distinct, sharp borders to lesions
  • single discrete lesion or clusters of lesions, often occur at sites of trauma
  • possibly covered with fine white streaks or linear scratch marks called Wickham's striae
  • shiny or scaly appearance
  • color dark, reddish-purple (skin) or gray-white (mouth)
  • possibility of developing blisters (bullae) or ulcers

• ridges in the nails (nail abnormalities)
• dry mouth
• metallic taste in the mouth
• mouth lesions
  • tender or painful (mild cases may have no discomfort)
  • located on the sides of the tongue or the inside of the cheek
  • occasionally located on the gums
  • poorly defined area of blue-white spots or "pimples"
  • linear lesions forming a lacy-appearing network of lesions
  • gradual increase in size of affected area
  • lesions occasionally erode to form painful ulcers

• hair loss

Signs and tests:

A distinctive appearance of the skin lesion coupled with a history of recurrence of lesions may indicate lichen planus. The health care provider or dentist may diagnose oral lichen planus based on the distinctive appearance of mouth lesions.

A skin lesion biopsy or biopsy of a mouth lesion confirms the diagnosis.