Cutaneous Lichen Planus
Papular lichen planus is the most common form. Classic purple polygonal papules are located on the flexor surfaces of the wrists and forearms, the ankles and the lumbar region. Antibodies to hepatitis C are detected in about 16% of patients with cutaneous lichen planus
Lesions that persist become thicker and dark red. These hypertrophic lesions are most often they are on the shins with papules aggregating into broad based plaques. Vesicles or bullae may appear. Persistent brown staining develops after the lesions resolve.
Follicular lichen planus occurs on the scalp with numerous follicle-based papules. Without treatment, permanent hair loss with marked scarring may occur. This form may be difficult to discern from lupus clinically. Scalp biopsy with immunofluorescence is often helpful in making this distinction.