Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 15;17(6):e86051.
doi: 10.7759/cureus.86051. eCollection 2025 Jun.

Clinical, Epidemiological, and Dermoscopic Features of Different Clinical Variants of Cutaneous Lichen Planus in the Indian Population: A Prospective Observational Study

Ashna Malhotra  1 , Arvind Krishna  1 , Robin Chugh  1 , Abhinav David  1
Affiliations

Clinical, Epidemiological, and Dermoscopic Features of Different Clinical Variants of Cutaneous Lichen Planus in the Indian Population: A Prospective Observational Study

Ashna Malhotra et al. Cureus. .

Abstract

Introduction: Lichen planus (LP) is a distinct clinical entity that commonly affects the skin, hair, nails, and mucous membranes. Multiple clinical variants of LP with varying morphologies have been documented. This study aimed to analyze the clinical, epidemiological, and dermoscopic features of different variants of cutaneous LP in the Indian population.

Methods: This prospective observational study was conducted at a tertiary care hospital from January 2021 to August 2022. A total of 50 patients with a confirmed diagnosis of cutaneous LP were included. Demographic details, including age, disease duration, symptoms, and family history, were recorded.

Results: Among the 50 patients, 30 (60%) were female and 20 (40%) male, with an age range of 8-65 years (mean age: 37 ± 14 years). Classical LP was the most common variant observed (26 cases, 52%), followed by lichen planus hypertrophicus (LPH) in eight cases (16%) and eruptive LP in six cases (12%). Wickham's striae (WS) was the most common dermoscopic finding in classical LP (observed in 23 cases, 88.5%), but was absent in LPH, actinic LP, and lichen planus pigmentosus (LPP). The most frequent pigmentation patterns in classical LP were diffuse dots and diffuse globules, seen in three cases (11.5%). Pigmentation patterns were more variable in LPH and actinic LP. The background color was pink in classical and eruptive LP, and brownish in LPH, actinic LP, and LPP. It showed mixed shades in annular atrophic LP. No significant differences in demographic parameters were noted among the different variants.

Conclusion: WS was the most consistent dermoscopic feature in cases of classical cutaneous LP and can assist physicians in diagnosis. Detailed dermoscopic evaluation, combined with a comprehensive clinical history, is essential for diagnosing classical and atypical LP variants and differentiating them from clinically similar conditions. This approach offers important clues regarding the underlying histopathology.

Keywords: dermoscopy; histopathology; lichen planus; pigmentation; wickham striae.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. University Ethics Committee (Medical), Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India issued approval SMC/UECM/2021/181, dated January 25, 2021. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Dermoscopic findings in classical lichen planus, pink background, white radial streaming Wickhams striae, red dots
Figure 2
Figure 2. Clinical photograph of classical lichen planus in a 22-year-old male participant who presented with multiple violaceous papules and plaques over bilateral ankles, associated with severe pruritus
See this image and copyright information in PMC

References

    1. Lichen planus. Boch K, Langan EA, Kridin K, Zillikens D, Ludwig RJ, Bieber K. Front Med (Lausanne) 2021;8:737813. - PMC - PubMed
    1. Cutaneous and mucosal lichen planus: a comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis. Gorouhi F, Davari P, Fazel N. ScientificWorldJournal. 2014;2014:742826. - PMC - PubMed
    1. A cross-sectional observational study of clinicodermatoscopic features in cutaneous lichen planus in Indian skin. Tatawati AS, Doshi BR, Manjunathswamy BS. https://journals.lww.com/pigi/fulltext/2021/08020/a_cross_sectional_obse... Pigment Int. 2021;8:100–108.
    1. Prevalence of metabolic syndrome in patients with lichen planus: a cross-sectional study from a tertiary care center. Hashba H, Bifi J, Thyvalappil A, Sridharan R, Sreenivasan A, Mathew P. Indian Dermatol Online J. 2018;9:304–308. - PMC - PubMed
    1. Oral lichen planus. Giannetti L, Dello Diago AM, Spinas E. https://pubmed.ncbi.nlm.nih.gov/29685024/ J Biol Regul Homeost Agents. 2018;32:391–395. - PubMed

LinkOut - more resources