Lichen planus is a chronic inflammatory skin condition that affects both the skin and mucous membranes. Dermoscopy, a non-invasive imaging technique, plays a crucial role in the diagnosis of lichen planus, providing valuable insights into its characteristic clinical features. This article will delve into the dermoscopic manifestations of lichen planus, highlighting its key findings and differential diagnoses.
Violaceous Papules and Plaques:
Lichen planus typically presents with violaceous or purplish papules and plaques that are polygonal in shape. These lesions are often grouped in a linear or symmetric pattern, known as Wickham's striae.
Wickham's Striae:
Wickham's striae are fine, white lines that run parallel to the edges of the papules and plaques. They are considered a highly specific finding for lichen planus.
White Network:
A white network of lines and dots may be visible on the surface of the lesions. This network results from the thickening of the epidermis and dilation of the hair follicles.
Milia-like Cysts:
Small, white cysts, known as milia-like cysts, are commonly observed in lichen planus. These cysts represent trapped keratin debris within the epidermis.
It is important to differentiate lichen planus from other skin conditions with similar dermoscopic features:
Condition | Key Dermoscopic Findings |
---|---|
Lichen Nitidus | Smaller, more uniform papules without Wickham's striae or white network |
Pityriasis Rosea | Pinkish or tan-colored ovals with a fine, central scale |
Subacute Cutaneous Lupus Erythematosus | Violaceous papules with follicular plugging and erosions |
Morbilliform Drug Reaction | Erythematous or violaceous macules and papules with a mottled or reticulated pattern |
Hypertrophic Lichen Planus:
This variant is characterized by thick, verrucous plaques that may resemble warts. Dermoscopy reveals a white or yellowish network with milia-like cysts.
Actinic Lichen Planus:
Actinic lichen planus occurs in sun-exposed areas and presents with violaceous or brown papules and plaques. Dermoscopy shows a white network and milia-like cysts, similar to classic lichen planus.
Lichen Planus Pigmentosus:
This variant is characterized by brown or black pigmentation on the skin. Dermoscopy may reveal a subtle white network and milia-like cysts.
Dermoscopy plays a valuable role in the diagnosis of lichen planus, particularly in cases where the clinical presentation is equivocal. The characteristic dermoscopic features, such as Wickham's striae and the white network, can aid in differentiating lichen planus from other similar conditions.
The treatment of lichen planus is tailored to the severity and extent of the condition. Treatment options may include:
To ensure an accurate diagnosis of lichen planus using dermoscopy, consider the following strategies:
Q1: How common is lichen planus?
A: Lichen planus affects approximately 1% of the population.
Q2: Can lichen planus be cured?
A: Lichen planus is a chronic condition, but it can be managed to控制 symptoms.
Q3: Is lichen planus contagious?
A: No, lichen planus is not contagious.
Q4: What is the prognosis of lichen planus?
A: The prognosis of lichen planus is generally good. Most cases resolve within a few years.
Q5: Can lichen planus lead to skin cancer?
A: Lichen planus itself does not lead to skin cancer, but the use of certain treatments, such as phototherapy, may increase the risk of developing skin cancer.
Q6: Can lichen planus affect other parts of the body?
A: Yes, lichen planus can affect the scalp, nails, and mucous membranes.
If you suspect you may have lichen planus, consult a healthcare professional for proper diagnosis and treatment. Early diagnosis and appropriate management can help to reduce symptoms and improve the quality of life.
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