Glossary On Variants

Lichen planus may present in different forms in different individuals. Certain variants respond better to treatment whereas others tend to be more obstinate. Depending on the presentation of the lesions (and their peculiar locations), following are the variants of lichen planus that have been described:

• Hypertrophic lichen planus (Lichen planus verrucosus) - thickened lesions of lichen planus usually seen on the extremities, especially the shin. It tends to be very itchy in nature.
• Atrophic lichen planus - a rare variant of lichen planus. It is characterized by plaques with central superficial atrophy.
• Bullous or Vesiculobullous lichen planus - another rare variant of lichen planus. Vesicles and bullae (fluid-filled lesions) are seen along with the lesions of lichen planus.
• Ulcerative lichen planus - is a rare variant of lichen planus. It presents with chronic, painful bullae and ulceration of the lesions.
• Follicular lichen planus (or Lichen planopilaris) - affection of the hair follicles leading to scarring is seen. There is hair loss from the affected parts.
• Lichen planus actinicus (Actinic lichen planus) - common in Middle East countries in spring and summer. Exposed areas of the face, dorsum of hands, arms and nape of the neck develop dark, lesions with rolled edges and well defined borders.
• Lichen planus pigmentosus - another rare variant where dark-brown spots develop in sun-exposed areas and folds of the skin.
• Annular lichen planus - Commonly involves the male genitalia but also has a predilection for folds of the skin such as the axilla and groin folds and marked by small clusters of lesions.
• Linear lichen planus - lesions develop along a straight line, usually on extremities. May develop secondary to trauma (Koebner's phenomenon).