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.
Management
- Topical steroids
- Anti-histamines
Prognosis
- 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
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