Lichen Planus Follow-up
- Author: Tsu-Yi Chuang, MD, MPH, FAAD; Chief Editor: William D James, MD more...
Malignant transformation has been reported in ulcerative oral lichen planus (OLP). Cutaneous hypertrophic lichen planus resulting in squamous cell carcinoma (SCC) was reported in a series of 38 patients. Pruritic and painful vulvar lichen planus has been a precursor to SCC in a small number of cases.
Infection, osteoporosis, adrenal insufficiency, bone marrow suppression, renal damage, hyperlipidemia, and growth restriction in children may occur due to medication adverse effects. Postinflammatory/residual hyperpigmentation may be a common marker after lichen planus has subsided. Alopecia associated with lichen planus is often permanent.
Hepatitis C virus infection may be present in 16% of lichen planus patients. Additionally, a meta-analysis reported that hepatitis C virus seropositivity could be 6 times higher in oral lichen planus patients than controls.
The prognosis for lichen planus is good, as most cases regress within 18 months. Some cases recur. In lichen planus, atrophy and scarring are seen in hypertrophic lesions and in lesions on the scalp. Cutaneous lichen planus does not carry a risk of skin cancer, but ulcerative lesions in the mouth, particularly in men, do have a low rate of malignant transformation. However, the malignant transformation rate of oral lichen planus is low (< 2% in one report). Vulvar lesions in women may also be associated with squamous cell carcinoma.
Patients should be told about the self-limiting nature of lichen planus. Because lichen planus is not common, no large, randomized, controlled clinical trials have been conducted for therapy. Several treatments may need to be tried.
Patients should be told about the small likelihood of recurrence and the potential adverse effects from the various treatments offered.
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