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Medical dermatology

Lichen Planus

An immune-mediated condition causing purple, itchy skin lesions and oral sores — diagnosed and managed by expert dermatologists in Miami.

Classic Features

  • Skin: flat, purple, polygonal, pruritic papules — often on wrists, ankles, lower back
  • Oral: reticular white patches (Wickham striae) or erosive lesions on gums and inner cheeks
  • Nails: ridging, thinning, and pterygium formation
  • Scalp (lichen planopilaris): follicular inflammation leading to scarring alopecia

Causes

The exact trigger is unknown, but T-cell-mediated immune attack on keratinocytes is central. Associations include hepatitis C virus infection, certain medications (thiazides, NSAIDs, antimalarials), and dental amalgam.

Treatment

  • Topical: high-potency corticosteroids (clobetasol), tacrolimus for oral/genital lesions
  • Intralesional: triamcinolone for hypertrophic variants
  • Systemic: hydroxychloroquine, acitretin, cyclosporine, mycophenolate mofetil
  • Phototherapy: narrowband UVB for widespread cutaneous disease

Monitoring

Erosive oral lichen planus carries a small risk (< 1%) of oral squamous cell carcinoma; regular follow-up is essential.

Frequently asked questions

Is lichen planus contagious?
No. Lichen planus is an autoimmune condition — it is not caused by a bacteria or virus and cannot spread from person to person.
Can lichen planus be cured?
Skin lichen planus often resolves within 1–2 years, though it can recur. Oral and nail lichen planus tends to be more chronic. Treatment controls symptoms and reduces flares but is not curative in all cases.

Most insurance plans cover medical dermatology procedures. Contact us to verify your benefits.

Trusted sources

This page is educational. Specific treatment decisions are made during your visit with Dr. Puyana.

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Choose a time that works for you. Online scheduling is through our practice calendar — same Coral Gables office, bilingual care. Self-pay and out-of-network new-patient visits are $150, credited toward a procedure done the same day.

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