Lichen planus

  • Symptoms
    • Mouth lesions
      • Tender or painful (mild cases may have no discomfort)
      • Located on the sides of the tongue or the inside of the cheek
      • Sometimes located on the gums
      • Area of blue-white spots or "pimples"
      • Lines of lesions that form a lacy-looking network
      • Gradual increase in size of the affected area
      • Lesions sometimes form painful ulcers
    • Skin lesions:
      • Usually located on the inner wrist, legs, torso, or genitals
      • Itchy
      • Even on both sides (symmetrical)
      • Single lesion or clusters of lesions, often at sites of skin injury
      • Papule 2 - 4 cm in size
      • Papules clustered into a large, flat-topped lesion
      • Lesions have distinct, sharp borders
      • Possibly covered with fine white streaks or scratch marks called Wickham's striae
      • Shiny or scaly appearance
      • Dark colored -- reddish-purple (skin) or gray-white (mouth)
      • Possibility of developing blisters or ulcers

    Other symptoms include:

    • Dry mouth
    • Hair loss
    • Metallic taste in the mouth
    • Ridges in the nails (nail abnormalities)

    Signs and tests

    The health care provider may make the diagnosis based on the appearance of the skin or mouth lesions.

    A skin lesion biopsy or biopsy of a mouth lesion can confirm the diagnosis. Blood tests may be done to rule out hepatitis.