Review Article

Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

Table 1

The most common sites of involvement in LP based on subtypes.

SubtypesMost common sites of involvement

CLP
ActinicSun-exposed areas such as face, V-chest, hands
AnnularMale genitalia (penis, scrotum), axilla, groin folds
AtrophicAll parts of body especially lower extremetities
ErosiveSoles of feet
FollicularScalp
GuttateTrunk
HypertrophicAnterior leg, ankles, and interphalangeal joints
LinearLeg-excoriated area
PapularFlexor surfaces (the main initial presentation)
Bullous Feet
PigmentosusSun exposed areas such as face, V-chest, hands
Pigmentosus-inversusIntertriginous and flexural areas
Nail involvementFingernails and toenails
Palmoplantar involvement(1) Malleoli
(2) Soles (internal plantar arch)
Lichen planopilaris(1) Vertex of scalp (classic type)
(2) Frontal of scalp (FFA type)

Mucosal LP
Oral
 Reticular(1) Buccal mucosa and mucobuccal folds
(2) Lateral and dorsal tongue
(3) Gingiva and lips
 AtrophicAttached gingiva
 HypertrophicBuccal mucosa
 Erosive(1) Lateral and ventral portions of tongue
(2) Buccal mucosa
 BullousPosterior and inferior areas of buccal mucosa
 Plaque-likeDorsum of the tongue and buccal mucosa
Vulvovaginal
 All subtypesVaginal introitus, clitoris, clitoral hood, labia minora, and majora, vagina
Esophageal (1) Proximal esophagus
(2) Proximal and distal esophagus
(3) Distal esophagus, strong possibility of concomitant mucosal involvement (80%)

FFA: frontal fibrosing alopecia, CLP: cutaneous lichen planus, FFA: frontal fibrosing alopecia, LP: lichen planus.