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Lichen planus

Lichen ruber planus

What it is

T cells attack the skin and mucosa, giving itchy purple bumps on the wrists and lacy white streaks inside the cheeks.

Symptoms & signs

  • Itchy flat-topped purple bumps (wrists, shins)
  • lacy white streaks in the mouth
  • painful mouth erosions
  • ridged or lost nails
  • scarring hair loss on the scalp

🚩 Get help if…

  • see a doctor soon A mouth sore that does not heal in 3 weeks or a lump
  • see a doctor soon Painful or bleeding genital sores or pain with sex
  • see a doctor soon Hair loss with scarring or nails splitting and falling off
  • see a doctor soon Soreness that stops you eating or drinking

Where it strikes

Medical treatment

  • Potent steroid cream or ointment
  • steroid mouthwash or gel for mouth disease
  • oral steroids for widespread disease
  • acitretin, methotrexate or tacrolimus
  • yearly mouth checks — the erosive oral form carries a small cancer risk

Natural & lifestyle

  • Avoid spicy and acidic food and SLS toothpaste with mouth disease
  • stop smoking and alcohol
  • test for hepatitis C
  • review drugs that trigger it

Emerging & experimental

  • JAK inhibitors (tofacitinib, baricitinib)
  • apremilast
  • photobiomodulation for oral lichen planus

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Aloe vera gel for oral lichen planus — small trials reduce pain early / small studies
  • Curcumin gel — small trials, similar to steroids in some early / small studies
  • Stress reduction and hypnosis — case reports anecdotal / traditional

ICD codes