What should you know about lichen planus?

Lichen planus commonly presents with itchy, raised bumps or flat-topped patches that may look purple, reddish, or brown depending on skin tone. Lesions can develop on the wrists, ankles, lower back, or legs and may leave darker marks after inflammation settles. The mouth, scalp, nails, and genital skin can also be involved, sometimes with different appearances. Scratching can create new areas along lines of injury. Examination may be enough, but a biopsy can clarify an uncertain case.

Use fragrance-free moisturiser, keep nails short, and reduce friction and scratching. A clinician may prescribe topical corticosteroids for localised skin disease; oral corticosteroid treatment or another approach may be discussed when symptoms are extensive or involve sensitive sites. Mouth or nail changes need specific examination. Keep a record of new medicines and products, because medication-related eruptions can resemble lichen planus.

Arrange a dermatology review for persistent itchy bumps, spreading rash, painful sores, scalp hair loss, nail distortion, or mouth lesions that make eating difficult. Seek prompt care for rapidly worsening pain, extensive blistering, eye symptoms, or signs of infection. Regular review may be advised for long-lasting mouth or genital disease.

Ask which sites are affected, whether a biopsy is useful, how long to use the prescribed cream, what side effects to watch for, and how scars or colour changes can be managed.