Lichen planus

Lichen planus is a chronic inflammatory disorder which presents as itchy, shiney flat-topped violaceous papules with white lines known as Wickham’s striae across the surface. 

Lichen planus can occur anywhere but is commonest in the flexures of the wrists and ankles. Other commonly affected areas include the mouth (involved in 50% of cases), female genitalia and nails. 

Nail signs in lichen planus are longitudinal ridges and onycholysis

  • Topical steroids 
  • Anti-histamines 

  • 50% resolve in 9 months 
  • Most are resolved by 18 months 
  • Relapse occurs in 20% 
  • Very rarely there is progression to squamous cell carcinoma 

Medications which can cause a lichenoid reaction include: 
  • Antimalarials 
  • NSAIDs 
  • Furosemide 
  • Ketoconazole 
  • Antibiotics 
    • Penicillin 
    • Tetracycline 
  • Beta blockers 
  • ACE-i 
  • Allopurinol
  • OCP 
  • Carbamazepine 
  • Lithium 

Metals that can cause a lichenoid reaction include: 
  • Mercury 
  • Nickel 

author profile image

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book.

Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)