Lichen Planus

Diagnosis

To identify the cause of your symptoms, a healthcare provider will review your medical history, ask about your symptoms, and perform a physical exam. Additional tests may be done, such as:

• Biopsy: A small piece of affected tissue is removed and examined in a lab to check for cell patterns typical of lichen planus.

• Blood tests: These may help find related health problems, such as hepatitis C.

Treatment

If you have no discomfort, treatment may not be necessary. Lichen planus on the skin often clears on its own within months to years. However, if symptoms are bothersome, treatment can help reduce itching, ease pain, and speed healing. Cases affecting the mucous membranes or nails can be more difficult to treat and may require long-term follow-up.

Corticosteroids

• First-choice treatment for skin lichen planus.

• Available as prescription creams, ointments, pills, or injections.

• Help reduce inflammation, swelling, and pain.

Oral Anti-Infection Drugs

Medicines sometimes used include:

• Hydroxychloroquine (Plaquenil)

• Metronidazole (Flagyl)

Immune Response Medicines

Used for more severe symptoms. Options include:

• Cyclosporine

• Azathioprine

• Methotrexate

• Mycophenolate

• Sulfasalazine

• Thalidomide
  More research is needed, but these medicines may help in some cases.

Antihistamines

• Taken by mouth to reduce itching.

Light Therapy (Phototherapy)

• UVB light exposure 2–3 times a week for several weeks.

• May help clear skin lesions.

• Possible side effect: long-term changes in skin color after healing.

Retinoids

• Can be taken orally or applied to the skin.

• Example: Acitretin.

• Not suitable during pregnancy or breastfeeding due to risk of birth defects.

Dealing With Triggers

If your condition is linked to:

• an infection,

• allergies, or

• a medication,

then treating the underlying cause, changing medicines, or doing allergy testing may be necessary.