Lichen planus is a precancerous condition. It is a common inflammatory disease that affects the skin and oral mucous membranes.

The term lichen means the the lesion looks like lichen present on the rock and planus means flat.

Causes to be written from net

Types of lichen planus

• Reticular
• Plaque-like
• Atrophic
• Ulcerative
• Erosive
• Bullous
• Follicular

Reticular type – it is the most common type of lichen planus seen. it consists of slightly elevated spots present at the intersection of white lines called Wickham’s striae.

Popular type- these are elevated white lesions seen in the keratinized areas of the oral mucosa. They are as small as 0.5mm to 1 mm. They are present in the form of papules (boil )which are a little far away from each other. They are grey or whitish.

Atrophic type – these are red and smooth areas. The attached gingival is usually involved.

Bullous type – it is present in the form of vesicles or bullae which rupture and form ulcerated areas. Most commonly affects the buccal mucosa and lateral surface of the tongue

Treatment

• Remove the cause
• Steroids include steroid sprays like beclomethazone propionate spray.
• Topical application of antifungal drugs like Nystatin and Ketoconazole.
• Combination of prednisolone and levamisole
• Surgical therapy.
• Psychotherapy.
• Dapsone therapy

Features of lichen planus

• It mainly involves the skin and oral mucous membrane. 
• It also involves the larynx, esophagus, penis, vulva, stomach, and mucosa of the nose. 
• The patient complains of severe itching and he feels like rubbing the lesion rather than scratching it.
• These lesions have a slight violet color. The top of the lesion is flat and shiny. the surface is dry.
• If oral lesions are present with genital lesions they are called vaginogingival syndrome. Lichen planus can be associated with Grinspan syndrome which includes lichen planus, diabetes mellitus, and vascular hypertension.
• In the oral mucosa, it commonly affects the lip, tongue, gums, and floor of the mouth.
• Patients may complain of a burning sensation in the oral mucosa.
• A characteristic feature of lichen planus is the presence of Wickham’s striae. (they are elevated spots present at the intersection of white lines)
• In some cases, lichen planus is associated with candidial infection.