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Lichen Planus Follow-up

  • Author: Tsu-Yi Chuang, MD, MPH, FAAD; Chief Editor: William D James, MD  more...
Updated: Mar 01, 2016


Malignant transformation has been reported in ulcerative oral lichen planus (OLP).[22] Cutaneous hypertrophic lichen planus resulting in squamous cell carcinoma (SCC) was reported in a series of 38 patients.[23] 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.[1]



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).[24] Vulvar lesions in women may also be associated with squamous cell carcinoma.


Patient Education

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.

Contributor Information and Disclosures

Tsu-Yi Chuang, MD, MPH, FAAD Clinical Professor, Department of Dermatology, Keck School of Medicine of the University of Southern California; Dermatologist, HealthCare Partners

Tsu-Yi Chuang, MD, MPH, FAAD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, International Society of Dermatology

Disclosure: Nothing to disclose.


Laura Stitle, MD Staff Physician, Department of Dermatology, Indiana University Medical Center

Laura Stitle, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Warren R Heymann, MD Head, Division of Dermatology, Professor, Department of Internal Medicine, Rutgers New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Joshua A Zeichner, MD Assistant Professor, Director of Cosmetic and Clinical Research, Mount Sinai School of Medicine; Chief of Dermatology, Institute for Family Health at North General

Joshua A Zeichner, MD is a member of the following medical societies: American Academy of Dermatology, National Psoriasis Foundation

Disclosure: Received consulting fee from Valeant for consulting; Received grant/research funds from Medicis for other; Received consulting fee from Galderma for consulting; Received consulting fee from Promius for consulting; Received consulting fee from Pharmaderm for consulting; Received consulting fee from Onset for consulting.

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Lichen planus on the flexor part of the wrist.
Close-up view of lichen planus.
Lichen planus shows Wickham striae (white, fine, reticular scales).
Lichen planus on the oral mucosa with ulceration in the center of the lesion appears with whitish papules and plaques in the periphery.
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