clinical features

Last reviewed 04/2022

Characterized by intensely itchy shiny red or purple flat-topped papules on the skin.

A more detailed description of the classical features of lichen planus lesions is presented below (1):

  • flat-topped
  • shiny
  • violaceous (pink/mauve/purple - the colour of the violaceae family of plants)
  • polygonal
  • fine, white lines forming a lace-like pattern on the surface - Wickham's striae

Other features:

  • typically they are seen on the inner aspects of the elbows, on the wrists, shins and sacral area
  • there may also be asymptomatic lesions on the inside of the mouth or on the genitalia
  • rarely the scalp is involved - can be affected in 2 main ways:
    • cicatricial alopecia
    • lichen planopilaris (follicular lichen planus) - red spiny papules can be seen around a cluster of hairs (1)
  • may be intense residual pigmentation after lesions resolve

Reference: