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Update on lichen planus and its clinical variants.

Int J Womens Dermatol

August 2015

Department of Dermatology, University of Connecticut Health Center, Farmington, CT.

Lichen planus (LP) is an inflammatory skin condition with characteristic clinical and histopathological findings. Classic LP typically presents as pruritic, polygonal, violaceous flat-topped papules and plaques; many variants in morphology and location also exist, including oral, nail, linear, annular, atrophic, hypertrophic, inverse, eruptive, bullous, ulcerative, lichen planus pigmentosus, lichen planopilaris, vulvovaginal, actinic, lichen planus-lupus erythematosus overlap syndrome, and lichen planus pemphigoides. Clinical presentation of the rarer variant lesions may be largely dissimilar to classic LP and therefore difficult to diagnose based solely on clinical examination.

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Bullous ulcerative lichen ruber planus (BULRP) in a 58-year-old woman is described. Besides the common symptoms (papular rash, vesicles and ulcers on the soles, detachment of the nail plates, atrophic foci on the hairy part of the head), the patient has developed erosions on the buccal and vaginal mucosa, articular involvement, complete loss of hair in the armpits and on the pubis. Local dibunol liniment has been effective in therapy of the mucosal erosions.

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