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Lichen planus - Anogenital in
See also in: Overview,Nail and Distal Digit
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Lichen planus - Anogenital in

See also in: Overview,Nail and Distal Digit
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Contributors: Jeffrey M. Cohen MD, Lauren Strazzula MD, Belinda Tan MD, PhD, Susan Burgin MD
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Synopsis

Lichen planus (LP) is a condition in which autoreactive T lymphocytes attack basal keratinocytes in the skin, mucous membranes, hair follicles, and/or nail units. The etiology is unclear, but viruses, medications, and contact allergens have all been implicated. LP may solely involve the penis but can also affect the skin more broadly, and can also affect hair follicles, the nail unit, and mucous membranes. See oral lichen planus for oral mucosal presentation and lichen planopilaris for scalp presentation.

Clinically, LP presents with flat-topped, reddish to purple papules. Penile LP most commonly presents on the glans and is often annular in configuration. Papules and plaques can erode, resulting in significant pain, scarring, and impairment of function.

Drugs causing LP-like eruptions (lichenoid drug reactions) include antihypertensives (angiotensin-converting enzyme [ACE] inhibitors: captopril and enalapril; beta blockers: propranolol and labetalol), thiazide diuretics, antimalarials (quinidine and hydroxychloroquine), penicillamine, NSAIDs, griseofulvin, tetracycline, antiepileptics, and many other drugs.

LP can spontaneously resolve, usually after a year, or follow a remitting or chronic course. LP of mucosal sites tends to be more chronic and treatment resistant than cutaneous LP.

Codes

ICD10CM:
L43.9 – Lichen planus, unspecified

SNOMEDCT:
4776004 – Lichen planus

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

For erosive lesions:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 05/07/2019
Last Updated: 05/07/2019
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Lichen planus - Anogenital in
See also in: Overview,Nail and Distal Digit
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Lichen planus (Overview) : Forearm, Koebner phenomenon, Polygonal configuration, Purple color, Wickham striae, Widespread, Wrist, Anterior lower leg, Pruritus
Clinical image of Lichen planus
Flat-topped violaceous, polygonal papules, some annular, with fine white scale at the wrist.
Copyright © 2019 VisualDx®. All rights reserved.