SEQUELA OF LICHEN PLANUS

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What is the treatment for a large scalp lesion diagnosed as lichen planus? Can these lesions evolve into squamous cell carcinoma (SCC) or other malignancy?
— Clarence R. Sanders, MD, Gallatin, Tenn.

Lichen planopilaris (LPP) affects primarily the scalp, resulting in scaling, atrophy, and alopecia with scarring. While hypertrophic, oral, and ulcerative lichen planus have been associated with SCC, I could find no cases of SCC in association with LPP in the literature. There are multiple therapeutic options for LPP, including topical, intralesional, and oral corticosteroids; oral antibiotics; antimalarial medications; systemic retinoids; methotrexate; and cyclosporine.
—Jeffrey M. Weinberg, MD (112-7)

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