Lichen planus in Adult
Clinically, patients present with pruritic, flat-topped, pink to purple papules that are localized most commonly along the volar wrists, shins, presacral area, and hands, but may be widespread. Oral LP and/or LP involving the genitalia can occur in isolation or in patients with cutaneous disease. Lichen planopilaris, a variant of LP affecting the follicular unit, presents with perifollicular erythema and scaling and leads to scarring alopecia. (Frontal fibrosing alopecia is a variant that is seen in older women. Another rare variant is the Graham-Little-Piccardi-Lassueur syndrome.) LP can also affect the nail matrix, resulting in fissuring, longitudinal ridging, and lateral thinning of the nails.
Certain medications cause an LP-like eruption. Culprits include captopril, enalapril, labetalol, propranolol, methyldopa, calcium channel blockers, NSAIDs, chloroquine, hydroxychloroquine, quinacrine, thiazide diuretics, etanercept, infliximab, penicillamine, quinidine, and gold salts.
LP has been described in association with hepatitis C, predominantly in certain geographical areas (Japan and Mediterranean regions). Hepatitis B vaccination as well as exposure to other bacteria and viruses has also been associated with LP in the literature. Oral LP may occur on mucosal surfaces apposed to amalgams and other dental restorative materials.
L43.9 – Lichen planus, unspecified
4776004 – Lichen planus
Differential Diagnosis & Pitfalls
Differential diagnosis of cutaneous LP:
Drug Reaction Data