How is Lichen Planus diagnosed?

How is Lichen Planus diagnosed?

Lichen planus is a chronic inflammatory condition that affects the skin, mucous membranes, hair, and nails. It is characterized by the development of itchy, flat-topped, purple-colored bumps or lesions. Diagnosing lichen planus involves a combination of clinical examination, medical history review, and sometimes additional tests.

Clinical Examination:

During a clinical examination, a healthcare professional will carefully examine the affected areas of the skin, mucous membranes, hair, or nails. They will look for the characteristic signs and symptoms of lichen planus, such as:

• Purple-colored bumps or lesions: These lesions are typically flat-topped and may have a shiny or scaly appearance.


• Itching: Lichen planus lesions are often accompanied by intense itching, which can be a significant source of discomfort for patients.


• Wickham's striae: These are fine, white lines or patterns that may be present on the surface of the lesions.


• Location: Lichen planus can occur on various parts of the body, including the wrists, ankles, lower back, mouth, genitals, scalp, and nails.

Medical History Review:

A thorough review of the patient's medical history is an essential part of the diagnostic process. The healthcare professional will ask questions about the patient's symptoms, their duration, any triggers or aggravating factors, and any previous medical conditions or treatments. It is important to provide accurate and detailed information to assist in the diagnosis.

Additional Tests:

In some cases, additional tests may be necessary to confirm the diagnosis of lichen planus or rule out other conditions with similar symptoms. These tests may include:

• Biopsy: A small sample of the affected skin, mucous membrane, or nail may be taken for microscopic examination. This can help identify the characteristic changes associated with lichen planus, such as a band-like lymphocytic infiltrate.


• Patch testing: Patch testing involves applying small amounts of potential allergens to the skin to determine if there is an allergic reaction. This test may be performed if an allergic contact dermatitis is suspected as a cause of lichen planus.


• Imaging studies: In rare cases where lichen planus affects the esophagus or other internal organs, imaging studies such as endoscopy or imaging scans may be recommended to assess the extent of involvement.


• Blood tests: Although there are no specific blood tests for lichen planus, certain blood tests may be ordered to rule out other conditions or assess the overall health of the patient.

Consultation with Specialists:

In some instances, a healthcare professional may refer the patient to a dermatologist, oral medicine specialist, or other relevant specialists for further evaluation and management of lichen planus. These specialists have expertise in diagnosing and treating conditions affecting the skin, mucous membranes, hair, and nails.

It is important to note that self-diagnosis or self-medication is not recommended. If you suspect you may have lichen planus or any other medical condition, it is crucial to seek professional medical advice for an accurate diagnosis and appropriate treatment.