This image displays typical flat-topped, purple (violaceous) elevations of the skin at the wrist in lichen planus. Lichen planus can cause erosions of the lips. Net-like, white, slightly elevated lesions inside the mouth are typical of oral lichen planus. In lichen planus, flat-topped, slightly elevated lesions with scaling are frequently located on the wrist. This image displays nails with thin, longitudinal ridges typical of lichen planus. As displayed in this image, lichen planus is typically seen as white patches on the sides of the mouth lining. Lichen planus (seen near the ankle area here) often has a purple-brown discoloration, sometimes with scale. Lichen planus lesions may be numerous. The typical purple-brown discoloration and dull appearance due to scaling are apparent here.
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Lichen Planus:
Information for adults

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Picture of Lichen Planus: This image displays typical flat-topped, purple (violaceous) elevations of the skin at the wrist in lichen planus. Divider line
This image displays typical flat-topped, purple (violaceous) elevations of the skin at the wrist in lichen planus.
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Treatments Your Physician May Prescribe
If lichen planus is suspected, your doctor may want to perform a skin biopsy. The procedure involves:
  1. Numbing the skin with an injectable anesthetic.
  2. Sampling a small piece of skin by using a flexible razor blade, a scalpel, or a tiny cookie cutter (called a "punch biopsy"). If a punch biopsy is taken, a stitch (suture) or 2 may be placed and will need to be removed 6–14 days later.
  3. Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).
In addition, your doctor may recommend one of the following treatments:
  • Topical corticosteroid (cortisone) cream, lotion, ointment, or gel
  • Topical tacrolimus or pimecrolimus
  • Anti-itch lotions containing menthol, pramoxine, or phenol
  • Corticosteroid (cortisone) injected directly into a thick lesion
  • Oral antihistamine pills such as diphenhydramine, loratadine, cetirizine, fexofenadine, desloratadine, or hydroxyzine for itching
In addition, your doctor may suggest one of the following treatments for oral lichen planus:
  • Topical corticosteroid (cortisone) ointment or gel
  • Topical cyclosporine solution used as a mouthwash
For very severe cases of lichen planus, one of the following therapies may be recommended:
  • Ultraviolet light treatment
  • Oral retinoid pills such as isotretinoin or acitretin
  • Oral cyclosporine pills
  • Oral hydroxychloroquine pills
Although there is no cure for lichen planus, treatment can usually minimize symptoms and improve the appearance of the rash until it heals.

Last Modified: 29 Jan 2008

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