Lichen planus ulcerosus L43.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

lichen ruber ulcerosus

Definition
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Rare special form of Lichen planus, which is highly chronic and extremely resistant to therapy. Ulerzation within the framework of a lichen planus can occur complicatively in 3 forms of progression:

  • 1. atrophying lichen planus (heals by scarring and atrophying; there is a secondary risk of ulcer formation)
  • Second Bullous Lichen planus. It occurs in 2 variants: as lichen planus bullosus with secondary formation of blisters and blisters in the lichen planus lesions; the 2 (possibly independent diseases clinical picture) course concerns the lichen (ruber) pemphigoides with blisters also occurring in unchanged skin. Secondarily, blisters can develop into erosions or ulcers.
  • 3. lichen planus palmo-plantaris: this clinically challenging variant is associated with nodular-verrucous lesions, erosions and pressure-induced ulcers that are highly resistant to treatment.

Localization
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Especially soles and back of the foot

Clinical features
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In most cases, extensive, highly painful flat ulcerations of the soles, backs of the feet and toes with nail loss and atrophying alopecia develop. This LP variant can be accompanied by a lichen planus mucosae as well as lichen planus foci in the area of the entire rest of the skin, but can also occur in isolation on the feet. Healing under extensive scarred atrophy.

Histology
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Therapy
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According to the Lichen planus. If the course of the disease is highly chronic over many years, a surgical procedure is recommended with excision of the ulcerations and covering of the split skin.

Progression/forecast
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If the course of the disease is extremely chronic, there is a risk of developing squamous cell carcinoma. In this respect a close clinical control of the findings is absolutely necessary.

Literature
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  1. Femiano F et al (2003) Oral erosive/ulcerative lichen planus: preliminary findings in an open trial of sulodexide compared with cyclosporine (ciclosporin) therapy. Int J Dermatol 42: 308-311
  2. Huwyler T et al (1989) Lichen ruber ulcerosus plantae. dermatologist 40: 28-30
  3. Kaliakatsou F et al (2002) Management of recalcitrant ulcerative oral lichen planus with topical tacrolimus. J Am Acad Dermatol 46: 35-41
  4. Matsuura A et al (2003) Severe generalized ulcerative lichen planus. Acta Derm Venereol 83: 145-146
  5. Sootworm R et al (1989) Lichen ruber ulcerosus. dermatologist 40: 233-235
  6. Vabres P et al (2002) Microchimerism from a dizygotic twin in juvenile ulcerative lichen planus. Lancet 359: 1861-1862
  7. by Meij EH et al (2003) The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96: 164-171

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Lichen planus erosivus;

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Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020