What should you know about lichen planus black skin?

Lichen planus is an inflammatory skin condition that can cause very itchy, firm, flat-topped or slightly raised bumps. In deeply pigmented skin, the original inflammation may be harder to recognise as red; shades of purple, grey, brown or deep black can be more noticeable. The wrists, ankles, lower back and shins are common areas, although other sites can be involved. Scratching may create new irritation and make colour change more pronounced. Dark marks can remain after active bumps improve, and their fading may be slower than the itch.

Arrange a dermatology assessment if new itchy bumps or unexplained dark patches are spreading. A clinician may examine the shape, surface and distribution, and may suggest a small skin sample when the appearance overlaps with another condition. Use fragrance-free moisturiser, keep nails short and avoid picking. Prescribed topical corticosteroids can calm local inflammation; more extensive disease may need an oral corticosteroid treatment plan. Do not apply strong steroid products to the face or skin folds without specific instructions.

Seek prompt medical care for painful open areas, rapidly changing lesions, swelling that affects the eyes or mouth, or signs of infection such as increasing warmth, pus or fever. Arrange review for sores in the mouth or genital area, difficulty eating, or persistent scalp or nail changes because these sites may need focused treatment.

Could these colour changes be active lichen planus or post-inflammatory darkening? Should another condition be ruled out? Which treatment is suitable for my skin tone and body site? How should I protect healing areas from irritation and sun-related darkening?