Materiały źródłowe

• #1 Lichen Planus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526126/

  Lichen planus is an inflammatory condition of unknown etiology affecting the skin and mucous membranes. […] This activity for healthcare professionals describes the epidemiology, genetics, diagnostic approaches, treatment options, and management strategies for cutaneous and oral forms of the disease. […] Evaluating lichen planus involves a comprehensive clinical assessment to accurately diagnose the condition and distinguish it from similar dermatological disorders. […] A biopsy with microscopic analysis is the most effective tool for confirming the presence of lichen planus. […] Incorporating direct immunofluorescence into histology can help differentiate lichen planus from other similar conditions, such as lupus erythematosus. […] Consideration of drug-induced lichen planus must always be explored before starting therapy.

• #2 Diagnosis and treatment of lichen planus – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21766756/

  Lichen planus is a chronic, inflammatory, autoimmune disease that affects the skin, oral mucosa, genital mucosa, scalp, and nails. Classic cases of lichen planus may be diagnosed clinically, but a 4-mm punch biopsy is often helpful and is required for more atypical cases. […] High-potency topical corticosteroids are first-line therapy for all forms of lichen planus, including cutaneous, genital, and mucosal erosive lesions. […] Topical corticosteroids are also first-line therapy for mucosal erosive lichen planus. […] Systemic corticosteroids should be considered for severe, widespread lichen planus involving oral, cutaneous, or genital sites. […] Referral to a dermatologist for systemic therapy with acitretin (an expensive and toxic oral retinoid) or an oral immunosuppressant should be considered for patients with severe lichen planus that does not respond to topical treatment.

• #3 Diagnosis and Treatment of Lichen Planus | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0701/p53.html

  Lichen planus can be diagnosed clinically in classic cases, although biopsy is often helpful to confirm the diagnosis and is required for more atypical presentations. A 4-mm punch biopsy should be adequate on the skin or in the mouth. The histology shows a characteristic saw-tooth pattern of epidermal hyperplasia; hyperparakeratosis with thickening of the granular cell layer; and vacuolar alteration of the basal layer of the epidermis, with an intense infiltration (mainly T cells) at the dermal-epidermal junction. A 4-mm punch biopsy of perilesional skin for direct immunofluorescence may be added to the workup when bullous lesions, pemphigus, or bullous pemphigoid is present. […] Lichen planus lesions are described using the six P’s (planar [flat-topped], purple, polygonal, pruritic, papules, plaques). Classic cases of lichen planus may be diagnosed clinically, but a 4-mm punch biopsy is often helpful and is required for more atypical cases.

• #4 Lichen Planus: What It Is, Causes, Types & Treatments

  https://my.clevelandclinic.org/health/diseases/17723-lichen-planus

  Your healthcare provider can typically diagnose lichen planus after assessing your symptoms and conducting a physical exam. They may look for characteristics known as the six Ps that help diagnose lichen planus: […] If there’s any doubt, your healthcare provider may perform the following tests: […] Allergy test. An allergy test can determine if you have an allergy that’s causing your lichen planus flare-up. […] Biopsy. Your healthcare provider will use a thin blade (scalpel) or a punch tool to collect a small sample of skin from your rash. Your skin sample goes to a laboratory for testing and pathologists examines it under a microscope. […] Hepatitis C test. Lichen planus is sometimes associated with the hepatitis C virus.

• #5 Lichen planus – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/624

  Lichen planus is an idiopathic inflammatory disease affecting the skin, hair, nails, and mucous membranes, usually self-limiting in nature. […] Characteristic eruption consists of itchy, shiny, flat-topped violaceous papules and plaques favouring the extremities. […] History and exam […] Key diagnostic factors […] pruritus […] violaceous, flat-topped papules or plaques […] Wickham’s striae […] mucosal erosions and lacy white network […] scarring alopecia […] nail involvement. […] 1st investigations to order […] clinical diagnosis. […] Investigations to consider […] histopathology […] hepatitis C (HCV) screen […] immunofluorescence.

• #6 Lichen planus – Wikipedia

  https://en.wikipedia.org/wiki/Lichen_planus

  Patient history and clinical presentation need to be taken to diagnose lichen planus. Patients with suspected cutaneous lichen planus need to be evaluated clinically through patient interviews and physical examinations. Patients should be questioned about their medication history, any history of pruritus or genital pain and history of dysphagia or odynophagia. Examination of entire cutaneous surface including the scalp, oral cavity and external genitalia need to be included. Wickham’s striae often can be seen during microscopic examination of cutaneous lesions of lichen planus. […] To confirm the diagnosis of cutaneous lichen planus, a skin biopsy can be done. A punch biopsy of sufficient depth to the mid dermis is usually significant. Immunofluorescence studies are not always needed. Direct immunofluorescence (DIF) can be useful in patients with bullous lesions to differentiate the condition from an autoimmune vesiculobullous disease.

• #7 Lichen planus – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/lichen-planus/

  Diagnosis is based on the presence of clinical features or typical histology; biopsy should be performed if the diagnosis is uncertain. […] Lichen planus is a clinical diagnosis. Diagnostic studies are indicated in patients with atypical, extensive, or refractory lesions. […] Dermoscopy: to improve visualization of lesions (e.g., Wickham striae), especially in individuals with darker skin. […] Biopsy: to exclude differential diagnoses and malignancy; see Pathology for histopathologic findings. […] Endoscopy for symptoms of esophageal involvement. […] Laboratory studies: Consider HCV screening, especially in individuals with risk factors for HCV infection. […] Perform a history and physical examination to assess all potential areas of involvement (i.e., cutaneous, mucosal, appendageal).

• #8 Lichen planus: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/lichen-planus-treatment

  Your board-certified dermatologist is trained to diagnose and treat conditions like lichen planus, which can affect your skin, hair, and nails. […] Your dermatologist can often diagnose lichen planus by: Examining your skin, scalp, nails, and mouth. […] Some patients also need a: Skin biopsy: To do this, your dermatologist removes a small sample from your rash, so that it can be examined under a microscope. […] Nail biopsy: If lichen planus may be affecting one or more of your nails, your dermatologist will remove a small sample from the suspected area, so that it can be examined under a microscope. […] Blood test to rule out other conditions. […] If the diagnosis is lichen planus, your dermatologist will decide whether you need treatment. […] When lichen planus affects your nails, diagnosing and treating it early are essential. Early treatment can stop this nail disease from worsening. […] To prevent nail disease from worsening, your dermatologist may include one or more of the following in your treatment plan. […] On the nails, lichen planus can be stubborn. To treat your nails, your dermatologist may include other medication as needed.

• #9 Lichen planus: Symptoms, Types, and Treatment with Images — DermNet

  https://dermnetnz.org/topics/lichen-planus

  Lichen planus is diagnosed clinically in most cases. A skin biopsy is often recommended to confirm the diagnosis and to look for cancer. The histopathological signs are of a lichenoid tissue reaction affecting the epidermis. […] Typical features include: Irregularly thickened epidermis, Wedge-shaped hypergranulosis, saw-tooth shaped rete ridges, Civatte bodies (apoptotic keratinocytes) in the lower epidermis and upper dermis, Liquefaction degeneration of the basal layer of the epidermis, Band-like lymphocytic infiltrate at the dermo-epidermal junction. […] Direct immunofluorescence studies are not routinely needed. Results may reveal colloid bodies in the papillary dermis with irregular deposits. […] Patch testing may be recommended for patients with oral lichen planus affecting the gums and who have amalgam fillings, to assess for contact allergy to thiomersal (a mercurial compound) and other metals.

• #10 Lichen Planus: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1123213-overview

  Diagnosis: Direct immunofluorescence study reveals globular deposits of immunoglobulin M (IgM) and complement mixed with apoptotic keratinocytes. No imaging studies are necessary. […] Distinguishing histopathologic features of LP include the following: Hyperkeratotic epidermis with irregular acanthosis and focal thickening in the granular layer; Degenerative keratinocytes (colloid or Civatte bodies) in the lower epidermis; in addition to apoptotic keratinocytes, colloid bodies are composed of globular deposits of IgM (occasionally immunoglobulin G [IgG] or immunoglobulin A [IgA]) and complement; Linear or shaggy deposits of fibrin and fibrinogen in the basement membrane zone; In the upper dermis, a bandlike infiltrate of lymphocytic (primarily helper T) and histiocytic cells with many Langerhans cells.

• #11 Lichen Planus: Symptoms and Treatment | Doctor

  https://patient.info/doctor/lichen-planus-pro

  Lichen planus can usually be diagnosed clinically and histology is not often required. Skin biopsy is characteristic: […] There is a 'saw-tooth’ pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal band-like lymphohistiocytic infiltrate (mainly T cells). […] This initially develops around blood vessels at the dermal/epidermal junction and disrupts the basal epidermal layer. […] There is a reduced number of melanocytes in this region and focal areas with a thicker granular layer and infiltrate (the 'Wickham’s striae’). […] Direct immunofluorescence shows globular deposits of IgM (occasionally IgG and IgA).

• #12 Lichen Planus Workup: Laboratory Studies, Imaging Studies, Histologic Findings

  https://emedicine.medscape.com/article/1123213-workup

  Direct immunofluorescence study in lichen planus (LP) reveals globular deposits of immunoglobulin M (IgM) and complement mixed with apoptotic keratinocytes. […] No imaging studies are necessary for lichen planus. […] The histopathologic features distinguish lichen planus based on the presence of irregular acanthosis and colloid bodies in the epidermis with destruction of the basal layer. The upper dermis has a bandlike („lichenoid”) infiltrate of lymphocytes and histiocytes. […] The inflammatory reaction pattern is characteristic. […] The epidermis is hyperkeratotic with irregular acanthosis and focal thickening in the granular layer. Degenerative keratinocytes, known as colloid or Civatte bodies, are found in the lower epidermis. In addition to apoptotic keratinocytes, colloid bodies are composed of globular deposits of IgM (occasionally immunoglobulin G [IgG] or immunoglobulin A [IgA]) and complement. Linear or shaggy deposits of fibrin and fibrinogen are noted in the basement membrane zone. […] The upper dermis has a bandlike infiltrate of lymphocytic (primarily helper T) and histiocytic cells with many Langerhans cells. The infiltrate is very close to the epidermis and often disrupts the dermal-epidermal junction.

• #13 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Lichen-Planus-Diagnosis.aspx

  Diagnosis of lichen planus is based on clinical grounds, namely, the appearance of the rash in the oral cavity or on the skin. […] The most common test is a 4-mm punch biopsy from an affected area, either on the skin or in the mouth. […] In many patients, the condition is associated with chronic hepatitis C. Thus testing for HCV is also performed in many patients, including HCV-RNA or HCV-specific CD4+ and CD8+ lymphocytes. […] In vesiculobullous forms of lichen planus, the skin adjacent to the lesion may be taken for biopsy, as a direct immunofluorescence (IF) microscopy of the sample will differentiate other bullous lesions (such as pemphigus) from this condition.

• #14 Oral Lichen Planus (OLP) Laboratory Testing | Beutner Labs

  https://www.beutnerlabs.com/oral-lichen-planus-olp-laboratory-testing

  Diagnosis of OLP is established by clinical examination with histopathologic confirmation. Direct immunofluorescence (DIF) examination is used to rule out autoimmune diseases (e.g., pemphigus, pemphigoid). Histopathologic diagnosis confirms the clinical diagnosis of OLP. The correlation between clinical and histopathologic diagnosis is crucial for definitive diagnosis of OLP. OLP necessitates additional biopsy for direct immunofluorescence assessment and/or histopathologic evaluation, so continued clinical follow-up after the initial biopsy is essential. […] The histopathologic features of OLP are characteristic and composed of hyperkeratosis of the epithelium, hydropic or liquefaction degeneration of basal epithelial cells, atrophy or acanthosis of spinous epithelial cells, saw-tooth epithelial ridges, a homogeneous eosinophilic deposit at the epithelium-connective tissue junction, and a band-like lymphocytic infiltrate in the superficial lamina propria.

• #15 Oral Lichen Planus (OLP) Laboratory Testing | Beutner Labs

  https://www.beutnerlabs.com/oral-lichen-planus-olp-laboratory-testing

  DIF is a diagnostic adjunct for OLP lesion. The characteristic DIF finding for OLP lesion is a deposit of fibrinogen in a shaggy pattern at the basement membrane zone in the absence of immunoglobulin and complement. DIF is often necessary to differentiate OLP from mucous membrane pemphigoid and pemphigus vulgaris. DIF finding for mucous membrane pemphigoid is a linear deposition of immunoglobulins (IgG, IgA or IgM) or complement 3 (C3) at the basement membrane zone of the epithelium, and that for pemphigus vulgaris is a lattice-like (or chicken wire) deposition of immunoglobulins (IgG or IgM) or C3 in the intercellular areas among epithelial cells.

• #16 Lichen planus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-planus/diagnosis-treatment/drc-20351383

  To find the cause of your illness, your health care provider will likely talk with you about your symptoms and medical history and do a physical exam. You may also need some tests. These might include: […] Your health care provider removes a small piece of affected tissue for examination in a laboratory. The tissue is examined to see if it has the cell patterns typical of lichen planus. […] You may have your blood drawn to test for health problems related to lichen planus. For example, hepatitis C. […] For lichen planus, some basic questions to ask your health care provider include: Do I need any tests? […] Your health care provider is likely to ask you a number of questions, such as: Have you recently started new medicines?

• #17 Oral lichen planus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/oral-lichen-planus/diagnosis-treatment/drc-20350874

  Your healthcare professional may make a diagnosis of oral lichen planus based on: […] Your healthcare professional also may request lab tests, such as: […] A biopsy. In this test, a small tissue sample is taken from one or more spots in your mouth. This sample is studied under a microscope to see if oral lichen planus is present. Other, more specialized microscopic tests may be needed to find immune system proteins commonly related to oral lichen planus. […] Blood tests. These tests may be done to find conditions such as hepatitis C, which may rarely be related to oral lichen planus, and lupus, which may look like oral lichen planus. […] Your healthcare professional will likely ask more questions based on your responses, symptoms and needs. Prepare for questions to make the most of your appointment time.

• #18 Lichen Planus – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/psoriasis-and-scaling-diseases/lichen-planus

  Lichen planus is a recurrent, pruritic, inflammatory eruption characterized by small, discrete, polygonal, flat-topped, violaceous papules that may coalesce into rough scaly plaques, often accompanied by oral and/or genital lesions. Diagnosis is usually clinical and supported by skin biopsy. […] Although the diagnosis of lichen planus is suggested by appearance of the lesions, similar lesions may result from any of the papulosquamous disorders, cutaneous lupus erythematosus, and secondary syphilis, among others. […] Typically, biopsy is done. […] If lichen planus is diagnosed, laboratory testing for liver dysfunction, including hepatitis B and C infections, should be considered. […] Diagnose LP by clinical appearance and, if necessary, biopsy.

• #19 Lichen Planus: Symptoms, Diagnosis, Treatment, and Risks

  https://www.healthline.com/health/lichen-planus

  Anytime you see or feel a rash on your skin, or lesions in your mouth or on your genitals, you should talk with a doctor as soon as possible. […] Your primary care doctor may send you to a dermatologist if a diagnosis of lichen planus is not obvious, or if your symptoms are making you very uncomfortable. […] Your primary care doctor or dermatologist may be able to tell that you have lichen planus simply by looking at your rash. However, a rash from other conditions can look like lichen planus. To confirm the diagnosis, you may need further tests. […] Tests can include: […] a biopsy, which means taking a small sample of your skin cells to view under a microscope […] an allergy test, to find out if you’re having an allergic reaction […] liver function tests, including a test for hepatitis C.

• #20 Role of modern imaging techniques for the in vivo diagnosis of lichen planus (Review)

  https://www.spandidos-publications.com/10.3892/etm.2018.6974

  Lichen planus (LP) is a chronic inflammatory skin disease that can sometimes affect mucosal surfaces, with unknown pathogenesis, even though it appears to be an autoimmune disease. The diagnosis of lichen planus is usually based on histopathological examination of the lesions. […] Nowadays, the classical invasive diagnostic methods are replaced by modern noninvasive techniques. In this review, we present the main noninvasive imaging methods (dermoscopy, reflectance confocal microscopy, optical coherence tomography, ultrasound and diffuse reflection spectrophotometry) used in the diagnosis and therapeutic monitoring of lichen planus. […] In lichen planus, the dermoscopy increases the accuracy of diagnosis, avoids skin biopsies commonly used and can be useful in the therapeutic monitoring by repeated investigation at different stages of treatment.

• #21 Role of modern imaging techniques for the in vivo diagnosis of lichen planus (Review)

  https://www.spandidos-publications.com/10.3892/etm.2018.6974

  Until now, in order to confirm the diagnosis of LP and start a correct treatment, biopsy and histopathological examination are required. […] Current trends for the diagnosis and especially the monitoring treatment response of certain skin and mucosal inflammatory diseases, such as psoriasis and acne, use modern non-invasive or minimally invasive techniques without the necessity of biopsy. […] The aim of this study is to review the role of modern in vivo imaging techniques such as dermoscopy, reflectance confocal microscopy (RCM), optical coherence tomography (OCT), diffuse reflection spectrophotometry and ultrasound in the investigation of LP lesions and their correlation with classical histopathological features. […] In LP, RCM examination reveals a well represented granular layer with large (25-35 m) polygonal cells containing a luminous grainy cytoplasm, corresponding to histological hypergranulosis.

• #22 Role of modern imaging techniques for the in vivo diagnosis of lichen planus (Review)

  https://www.spandidos-publications.com/10.3892/etm.2018.6974

  Considering the aforementioned findings, it is without doubt that RCM can be of great aid in supporting the clinical diagnosis of LP. […] These initial reports suggest that OCT could be an useful auxiliary tool in the in vivo differential diagnosis of LP, especially in clinical equivocal settings such as mucosal lesions, and in monitoring the response to treatment. […] Our review shows the possibility of using modern imaging techniques for the in vivo diagnosis and also for evaluation of the treatment response.

• #23 Original paperClinical diagnosis of oral erosive lichen planus by direct oral microscopy

  https://www.termedia.pl/Original-paper-Clinical-diagnosis-of-oral-erosive-lichen-planus-by-direct-oral-microscopy,7,22332,0,1.html

  Direct oral microscopy is a novel, non-invasive diagnostic technique that aids clinical examination of the oral cavity. […] Oral lichen planus (OLP) is an autoimmune, inflammatory, chronic disease affecting oral mucous membranes. […] The study also demonstrates the utility of the method in the selection of the most appropriate biopsy site. […] Biopsies obtained based on direct oral microscopy revealed dysplasia in 16 patients (53.3%). Biopsies obtained based on clinical examination with the naked eye revealed dysplasia in 3 cases (10%). […] Direct oral microscopy makes it possible to obtain a repeated picture of erosive OLP and constitutes an alternative to the clinical examination with the naked eye in election of the most appropriate biopsy site. Thus, introduction of the most accurate and early therapy is possible.

• #24 Lichen Planus Types, Symptoms, and Options for Treatment

  https://www.verywellhealth.com/lichen-planus-1069573

  Other tests may be ordered to rule out conditions that mimic LP, such as: Drug skin eruption, Psoriasis, Atopic dermatitis, Cutaneous lupus erythematosus, Discoid lupus erythematosus, Allergic contact mucositis, Desquamative gingivitis, Leukoplakia, Oral squamous cell carcinoma, Oropharyngeal candidiasis.

• #25

  https://link.springer.com/article/10.1007/s40257-023-00814-3

  Oral lichen planus (OLP) is a chronic inflammatory disease whose pathogenesis involves a T-cell mediated, epithelium-directed inflammation in response to unknown antigen(s). […] Follow-up of patients is necessary to detect transformation into squamous cell carcinoma, occurring in approximately 1% of patients. […] Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. […] Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. […] Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. […] Clinicopathologic correlation of oral lichen planus and oral lichenoid lesions: a preliminary study.

• #26

  https://journals.lww.com/jpat/fulltext/2021/25030/diagnosis_and_management_of_oral_lichen_planus__.4.aspx

  Oral lichen planus (OLP) is an auto immune, common, chronic T-cell-mediated inflammatory disorder of the skin and mucous membranes that occurs in various clinical forms that often poses a diagnostic and therapeutic challenge due to its refractory course and relapsing nature. […] Diagnosis of OLP is challenging because of the presence of overlapping clinical and histopathological features. The diagnosis of an OLP may be made on visual examination without any biopsy when the lesion presents with the characteristic Wickham’s striae. […] The investigations include (1) cytology, (2) hematology and (3) biopsy (histopathological and immunofluorescence). […] The histopathology is the gold standard method used in diagnosing OLP. […] In 1978, WHO formulated diagnostic criteria for OLP, which included both clinical and histopathological features for consideration.

• #27 Integrative Approaches for the Diagnosis and Management of Erosive Oral Lichen Planus

  https://www.mdpi.com/2075-4418/14/7/692

  Erosive oral lichen planus (EOLP) represents a significant challenge in dental and medical management due to its chronic inflammatory nature, painful symptoms, and impact on quality of life. […] The diagnosis of erosive oral lichen planus (EOLP) is primarily clinical and relies on the appearance of the lesions and associated symptomatology and their progression over time. While a microscopic examination can provide supporting evidence for the diagnosis, its principal purpose is the identification of potential malignant transformation of suspicious lesions. When conducting microscopic examinations, it is crucial to obtain samples from the periphery of EOLP lesions for optimal diagnostic accuracy. […] The diagnosis of erosive oral lichen planus (EOLP) is primarily clinical, requiring a thorough examination and a detailed patient history to distinguish it from similar mucosal conditions. Key diagnostic features include the presence of painful, erythematous lesions with ulcerations, often accompanied by Wickham’s striae on the mucosa.

• #28 Oral Lichen Planus: A Narrative Review Navigating Etiologies, Clinical Manifestations, Diagnostics, and Therapeutic Approaches

  https://www.mdpi.com/2077-0383/13/17/5280

  Oral Lichen Planus (OLP) is a common immune-mediated inflammatory disorder affecting the oral mucosa, impacting 0.5% to 2% of the global population, primarily middle-aged women. […] Diagnosis relies on clinical examination, histopathology, and direct immunofluorescence. […] Recent advancements in diagnostic markers and imaging techniques have improved detection and monitoring. […] Regular screenings and biopsies are essential due to OLP’s likelihood of malignant transformation. […] The primary aim of this review is to provide a comprehensive exploration of the latest insights into the factors contributing to the development of OLP, the diagnostic methods and techniques, and the various strategies for effectively managing this complex oral disorder. […] Diagnosis of OLP is challenging because of overlapping clinical and histopathological features. Investigations include biopsy (histopathological and immunofluorescence), in addition to other tests.

• #29 Integrative Approaches for the Diagnosis and Management of Erosive Oral Lichen Planus

  https://www.mdpi.com/2075-4418/14/7/692

  Dermatoscopy, when applied to the oral mucosa (mucoscopy), significantly enhances the diagnostic approach to erosive oral lichen planus (EOLP). This non-invasive technique provides a magnified view of EOLP’s distinctive morphological characteristics, facilitating differentiation from similar mucosal lesions. […] A biopsy of the lesion is critical for confirming the diagnosis. Histopathological examination of hematoxylin–eosin-stained tissue samples reveals a band-like lymphocytic infiltrate just below the epithelial layer, hyperkeratosis, and sometimes, Civatte bodies (apoptotic keratinocytes). Direct immunofluorescence can further aid in diagnosis by showing fibrinogen deposits in a shaggy pattern along the basement membrane. […] While there are no specific biomarkers for EOLP, the differential diagnosis should rule out conditions such as pemphigus vulgaris, mucous membrane pemphigoid, and other forms of lichen planus affecting different body sites.

• #30 Erosive lichen planus

  https://dermnetnz.org/topics/erosive-lichen-planus

  Erosive lichen planus is a chronic and painful condition affecting mucosal surfaces, mainly the mouth (oral lichen planus) and the genitals (vulval or penile lichen planus). […] The diagnosis of erosive lichen planus is often made by the typical history and clinical appearance. A biopsy may be recommended to confirm the diagnosis and to look for cancer. Histopathological signs of a lichenoid tissue reaction affecting the epidermis (the skin cell layer) are supportive. […] However, the ulcerating nature of the disorder means that the epidermis may be missing so that lichenoid features may not be observed. The pathologist may describe a brisk inflammatory infiltrate in the mucosa, but this is non-specific. […] Direct immunofluorescent staining of tissue may also be helpful.

• #31 Lichen Planus Symptoms

  http://www.askdrshah.com/app/lichen-planus/lichenplanus-diagnosis.aspx

  lichen planus diagnosis Lichen Planus can be diagnosed clinically by experienced eyes. Lesions on the skin have a typical look as described elsewhere on these pages, and their location, such as legs, back, mouth, scalp, genitals, nails, or elsewhere (more or less in this order), is important for diagnosis. In case of doubt or to confirm the diagnosis, a biopsy would help. A biopsy is more often indicated in cases of oral and scalp Lichen Planus. At times, you need to do a biopsy to confirm the diagnosis of scalp Lichen Planus. When the oral mucosa or the genitals are affected, this condition is often neglected, reported late, or incorrectly diagnosed. […] Lichen Planus affecting the food pipe (esophagus) is not a commonly encountered condition. However, some cases have been reported at some institutes.

• #32 Enhanced Care for Pediatric Patients With Generalized Lichen Planus: Diagnosis and Treatment Tips | MDedge

  https://blogs.the-hospitalist.org/content/enhanced-care-pediatric-patients-generalized-lichen-planus-diagnosis-and-treatment-tips

  Timely and accurate diagnosis of LP in pediatric patients, especially those with skin of color, is crucial. […] The most common approach to management of pediatric LP involves the use of a topical corticosteroid and an oral antihistamine, but the recalcitrant and generalized distribution of lesions warrants the administration of a systemic corticosteroid regardless of the patient’s age. […] Administered every 3 to 6 weeks, these injections provide rapid symptom relief, typically within 72 hours, while also contributing to the reduction of lesion size and thickness over time. […] Patients should be monitored vigilantly for complications of LP. The risk for postinflammatory hyperpigmentation is a particular concern for patients with skin of color. […] Regular and thorough follow-ups every few months to monitor scalp, mucosal, and genital involvement are essential to manage this risk effectively.

• #33 Oral Lichen Planus: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17875-oral-lichen-planus

  A healthcare provider can diagnose oral lichen planus by examining your mouth. In many cases, providers take a tissue biopsy to confirm the diagnosis and rule out other diseases. […] Treatment for OLP focuses on reducing symptoms and preventing flare-ups. This means you may not need treatment if you don’t have symptoms that are bothering you. […] If you have symptoms, your healthcare provider will likely recommend medications. Some may calm your immune system so there’s less inflammation. Others relieve pain. Common oral lichen planus treatments include: […] Once you’re diagnosed with oral lichen planus, you’ll need regular check-ups to keep tabs on your condition. This is the case even if you’re going through a period with no symptoms. For example, it’s important that your healthcare provider checks for precancerous changes. You may need more frequent dental cleanings to keep your mouth healthy.

• #34 Oral Lichen Planus

  https://www.aaom.com/oral-lichen-planus

  Lichen planus is a disease that can affect the skin and any lining mucosa. […] The diagnosis must be obtained from a qualified health care professional. Usually, a biopsy is advisable to establish the diagnosis and rule out other diseases. […] This association remains controversial, but there are reported cases of this occurring. This concern reinforces the essential need to obtain an accurate diagnosis, typically with a biopsy. All patients with oral lichen planus should have a periodic evaluation to assess the efficacy of therapy and to monitor for suspicious changes.

• #35 Enhanced Care for Pediatric Patients With Generalized Lichen Planus: Diagnosis and Treatment Tips | MDedge

  https://www.mdedge.com/cutis/article/270742/pediatrics/enhanced-care-pediatric-patients-generalized-lichen-planus-diagnosis

  Timely and accurate diagnosis of LP in pediatric patients, especially those with skin of color, is crucial. […] Although not present in our patient, it is important to note that LP can affect the face (including the eyelids) as well as the palms and soles in pediatric patients with skin of color. […] The most common approach to management of pediatric LP involves the use of a topical corticosteroid and an oral antihistamine, but the recalcitrant and generalized distribution of lesions warrants the administration of a systemic corticosteroid regardless of the patient’s age. […] Administered every 3 to 6 weeks, these injections provide rapid symptom relief, typically within 72 hours, while also contributing to the reduction of lesion size and thickness over time. […] Patients should be monitored vigilantly for complications of LP. The risk for postinflammatory hyperpigmentation is a particular concern for patients with skin of color. Other complications of untreated LP include nail deformities and scarring alopecia. […] Regular and thorough follow-ups every few months to monitor scalp, mucosal, and genital involvement are essential to manage this risk effectively.

• #36 Lichen Planus | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/24254

  Lichen planus is an inflammatory disorder affecting the skin and mucous membranes with no known cause. […] The natural course of lichen planus varies significantly. Most patients with cutaneous lesions spontaneously clear within 1 to 2 years after initial presentation. […] Drug-induced lichen planus gradually resolves once the causative medication is discontinued. […] Skin biopsy and microscopic analysis are valuable in confirming the diagnosis in atypical and severe cases, as the histopathologic features are generally the same regardless of the distribution or subtype. […] A biopsy with microscopic analysis is the most effective tool for confirming the presence of lichen planus. […] Evaluating lichen planus involves a comprehensive clinical assessment to accurately diagnose the condition and distinguish it from similar dermatological disorders.

• #37

  https://link.springer.com/article/10.1007/s40257-024-00878-9

  Lichen planus (LP), an idiopathic, multifaceted chronic inflammatory disease with a heterogeneous clinical presentation, affects approximately 0.51% of the population. […] Familiarity with these potential associations in conjunction with long-term follow-up and regular screening could lead to a timely diagnosis and management of concomitant conditions. […] This contemporary review focuses on the diagnosis and management of LP, and places emphasis on more recently described targeted treatment options. […] The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. […] Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. […] Direct immunofluorescence as a helpful tool for the differential diagnosis of oral lichen planus and oral lichenoid lesions.

• #38 Lichen Planus | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/24254

  Lichen planus may affect the skin, scalp, and mucosal organs and is relatively difficult to cure. […] Given that lichen planus may result from various exogenous agents such as viruses, drugs, or contact allergens, care should be taken to identify and treat any underlying causes before diagnosing idiopathic lichen planus. […] Cutaneous lichen planus often resolves spontaneously within 1 to 2 years, but residual hyperpigmentation is common. […] Oral lichen planus may resolve spontaneously within 5 years, but typically, it is a chronic disease with a remitting and relapsing course. […] Consideration of drug-induced lichen planus must always be explored before starting therapy.

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