What should you know about dermoscopy of lichen planus?

Lichen planus can produce itchy, flat-topped bumps or patches, and it may leave darker marks after inflammation settles. With dermoscopy, the clinician examines the surface and the colour pattern within or around a lesion. They may look for a fine pale network, characteristic dots or streaks, and signs of scale or regression. These clues are interpreted with the shape, distribution, symptoms, medicines, and duration of the rash. Dermoscopy can strengthen an assessment, but similar patterns can occur in other inflammatory or pigmented conditions, so it does not replace a full examination.

Before the appointment, note where the rash started, whether it is spreading, and what makes the itching better or worse. Mention new medicines, dental materials, infections, and any changes in the mouth, nails, scalp, or genital skin. Keep the area moisturised and avoid scratching, which can thicken skin and create additional marks. Depending on the appearance, the dermatologist may recommend a topical corticosteroid, an oral corticosteroid treatment, another therapy, or a biopsy when the diagnosis is uncertain.

Seek assessment for a rash that is spreading, intensely itchy, painful, blistering, or interfering with sleep. Arrange prompt care for sores in the mouth or genital area, difficulty eating, eye symptoms, or a rapidly changing solitary lesion. Lichen planus can affect more than the skin, and these locations may need targeted examination. Do not assume every purple or scaly bump has the same cause; a clinician should review persistent or changing areas.

Ask which dermoscopic features support lichen planus, whether a biopsy is useful, and which body sites should be checked. Ask how to use prescribed treatment, how to reduce scratching, whether dark marks may fade, and which mouth, nail, or genital symptoms need earlier review.