Lichen planus atrophicans L43.81

Rare variant of lichen planus (<1% of all lichen planus cases) with epithelial atrophy and focal hyperpigmentation; clinically, similarities to generalized lichen sclerosus et atrophicus may be found.

In particular, anular lichen planus tends to show central atrophy of the lesions. Atrophy is also observed as a healing stage of lichen planus. In this respect, it also subsumes disease states that occur during the course of long-standing lichen planus.

Atrophies are also observed in lichen planus affecting the nails up to complete loss of the nails.

Furthermore, lichen planopilaris leads to follicular atrophy and focal hair loss. Atrophy as a consequence of healing can also be observed in bullous lichen planus.

Mostly few, centrally sunken, 0.2-0.5 cm, but also brownish, occasionally bluish lesions confluent to larger anular plaques with atrophic parchment-like surface. Loss of hair and follicular ostia.

1. Arduino PG et al (2014) Pimecrolimus vs. tacrolimus for the topicaltreatment
   of unresponsive oral erosive lichen planus: a 8 week randomizeddouble-blind
   controlled study.J Eur Acad Dermatol Venereol 28:475-482

2. Li B et al (2010) Annular atrophic lichen planus. Eur J Dermatol 20:842-843

3. Pandhi D et al. (2014) Lichen planus in childhood: a series of 316 patients.
   Pediatric dermatol 31: 59-67.

4. Sugashima Y et al. (2012) Annular atrophic lichen planus of the lip. Dermatol Online J 18:14