eMedicine Specialties > Dermatology > Reactive & Inflammatory Dermatoses

Lichen Planus: Follow-up

Author: Tsu-Yi Chuang, MD, MPH, Clinical Professor, Department of Dermatology, University of Southern California; Staff Dermatologist, Desert Specialty Group, Inc
Coauthor(s): Laura Stitle, MD, Staff Physician, Department of Dermatology, Indiana University Medical Center
Contributor Information and Disclosures

Updated: Oct 16, 2009

Follow-up

Complications

  • Oral ulcerations associated with lichen planus (LP) have the potential to become malignant. Malignant transformation has been reported in ulcerative oral lesions in men.16
  • Infection, osteoporosis, adrenal insufficiency, bone marrow suppression, renal damage, hyperlipidemia, and growth retardation in children may occur due to medication.
  • Alopecia is often permanent.
  • Hypertrophic lesions may leave residual hyperpigmentation.
  • Vulvar lesions can be pruritic and painful.
  • Hepatitis C virus infection may be present in 16% of lichen planus patients.

Prognosis

  • The prognosis for lichen planus is good, as most cases regress within 18 months. Some cases recur.

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.
 


More on Lichen Planus

Overview: Lichen Planus
Differential Diagnoses & Workup: Lichen Planus
Treatment & Medication: Lichen Planus
Follow-up: Lichen Planus
Multimedia: Lichen Planus
References
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References

  1. Chuang TY, Stitle L, Brashear R, Lewis C. Hepatitis C virus and lichen planus: A case-control study of 340 patients. J Am Acad Dermatol. Nov 1999;41(5 Pt 1):787-9. [Medline].

  2. [Best Evidence] Shengyuan L, Songpo Y, Wen W, Wenjing T, Haitao Z, Binyou W. Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis. Arch Dermatol. Sep 2009;145(9):1040-7. [Medline].

  3. Bigby M. The relationship between lichen planus and hepatitis C clarified. Arch Dermatol. Sep 2009;145(9):1048-50. [Medline].

  4. Korkij W, Chuang TY, Soltani K. Liver abnormalities in patients with lichen planus. A retrospective case-control study. J Am Acad Dermatol. Oct 1984;11(4 Pt 1):609-15. [Medline].

  5. Manolache L, Seceleanu-Petrescu D, Benea V. Lichen planus patients and stressful events. J Eur Acad Dermatol Venereol. Apr 2008;22(4):437-41. [Medline].

  6. Ingafou M, Leao JC, Porter SR, Scully C. Oral lichen planus: a retrospective study of 690 British patients. Oral Dis. Sep 2006;12(5):463-8. [Medline].

  7. Murphy R, Edwards L. Desquamative inflammatory vaginitis: what is it?. J Reprod Med. Feb 2008;53(2):124-8. [Medline].

  8. Balasubramaniam P, Ogboli M, Moss C. Lichen planus in children: review of 26 cases. Clin Exp Dermatol. Jul 2008;33(4):457-9. [Medline].

  9. Belfiore P, Di Fede O, Cabibi D, et al. Prevalence of vulval lichen planus in a cohort of women with oral lichen planus: an interdisciplinary study. Br J Dermatol. Nov 2006;155(5):994-8. [Medline].

  10. Di Fede O, Belfiore P, Cabibi D, et al. Unexpectedly high frequency of genital involvement in women with clinical and histological features of oral lichen planus. Acta Derm Venereol. 2006;86(5):433-8. [Medline].

  11. [Guideline] American College of Obstetricians and Gynecologists. Diagnosis and management of vulvar skin disorders. National Guideline Clearinghouse. May 2008.

  12. Cribier B, Frances C, Chosidow O. Treatment of lichen planus. An evidence-based medicine analysis of efficacy. Arch Dermatol. Dec 1998;134(12):1521-30. [Medline].

  13. Lim KK, Su WP, Schroeter AL, Sabers CJ, Abraham RT, Pittelkow MR. Cyclosporine in the treatment of dermatologic disease: an update. Mayo Clin Proc. Dec 1996;71(12):1182-91. [Medline].

  14. Conrotto D, Carbone M, Carrozzo M, Arduino P, Broccoletti R, Pentenero M, et al. Ciclosporin vs. clobetasol in the topical management of atrophic and erosive oral lichen planus: a double-blind, randomized controlled trial. Br J Dermatol. Jan 2006;154(1):139-45. [Medline].

  15. Pavlotsky F, Nathansohn N, Kriger G, Shpiro D, Trau H. Ultraviolet-B treatment for cutaneous lichen planus: our experience with 50 patients. Photodermatol Photoimmunol Photomed. Apr 2008;24(2):83-6. [Medline].

  16. Gonzalez-Moles MA, Scully C, Gil-Montoya JA. Oral lichen planus: controversies surrounding malignant transformation. Oral Dis. Apr 2008;14(3):229-43. [Medline].

  17. Boyd AS, Neldner KH. Lichen planus. J Am Acad Dermatol. Oct 1991;25(4):593-619. [Medline].

  18. Champion RH, ed. Rook/Wilkinson/Ebling Textbook of Dermatology. Vol 3. 6th ed. Malden, Mass: Blackwell Science; 1998:199-1916.

  19. Fitzpatrick T, Eisen A, Wolff K, et al. Dermatology in General Medicine. Vol 1. 4th ed. New York, NY: McGraw-Hill; 1993:1134-44.

  20. Lewis FM. Vulval lichen planus. Br J Dermatol. Apr 1998;138(4):569-75. [Medline].

  21. Murphy R, Edwards L. Desquamative inflammatory vaginitis: what is it?. J Reprod Med. Feb 2008;53(2):124-8. [Medline].

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Further Reading

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Keywords

lichen planus, LP, actinic lichen planus, annular lichen planus, atrophic lichen planus, erosive lichen planus, follicular lichen planus, guttate lichen planus, hypertrophic lichen planus, linear lichen planus, vesicular lichen planus, papular eruption, Wickham stria, hyperpigmentation, subungual hyperkeratosis, onycholysis, longitudinal melanonychia, atrophic cicatricial alopecia, pseudopelade, HLA-B7, HLA-DR1, HLA-DR10

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Contributor Information and Disclosures

Author

Tsu-Yi Chuang, MD, MPH, Clinical Professor, Department of Dermatology, University of Southern California; Staff Dermatologist, Desert Specialty Group, Inc
Tsu-Yi Chuang, MD, MPH is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, and International Society of Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

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.

Medical Editor

David P Fivenson, MD, Associate Director, St Joseph Mercy Hospital Dermatology Program, Ann Arbor, Michigan
David P Fivenson, MD is a member of the following medical societies: American Academy of Dermatology, Medical Dermatology Society, Michigan Dermatological Society, Michigan State Medical Society, Photomedicine Society, Society for Investigative Dermatology, and Wound Healing Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Warren R Heymann, MD, Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey
Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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