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Old 07-18-2011
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Skin Lichen planus

  • Lichen planus is a skin disorder that most commonly affects middle-aged adults. The disease may remit within one to two years or may be chronic. Clinicians should be aware of the potential for drug-induced forms of lichen planus.
  • Studies have suggested an association of lichen planus with hepatitis C virus (HCV), although the strength of this association varies geographically. Further studies are necessary to determine if HCV screening should be performed in patients with lichen planus.
  • Lichen planus may affect the skin, nails, or mucous membranes. Cutaneous lichen planus typically presents as pruritic, polygonal, violaceous papules and/or plaques with an overlying white, lacelike pattern (Wickham's striae). Significant post-inflammatory hyperpigmentation is common. Cutaneous lichen planus may also present with hypertrophic or vesicobullous lesions.
  • Lichen planopilaris is a form of lichen planus that affects the scalp and can lead to scarring alopecia. When lichen planus involves the oral cavity, it may present with only lacelike Wickham's striae or may include papular, atrophic, or erosive lesions. Genital areas can also be affected by lichen planus.
  • Localized cutaneous lichen planus and oral lichen planus are usually managed with topical corticosteroids. In cases of widespread cutaneous disease or severe, recalcitrant, erosive oral lichen planus, systemic medications (including glucocorticoids or retinoids) may be prescribed. Phototherapy has also been used for the treatment of widespread cutaneous disease.
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