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Description: Lichen planus is a non-neoplastic epithelial disorder that affects glabrous skin, hair-bearing skin and scalp, nails, mucous membranes, or the oral cavity and vulva.
Prevalence: Unknown, but relatively common. Estimated to affect 0.5%–2% of the population.
Predominant Age: 30–60 years; peak age 50–60 years.
Genetics: No genetic pattern.
Causes: Unknown. Proposed—autoimmune disorder, possibly initiated by certain drugs such as β-blockers and angiotensin-converting enzyme (ACE) inhibitors. Considered to arise from a T-cell–mediated autoimmune response against basal keratinocytes.
Risk Factors: None known.
Vulvar pain, burning, pruritus, soreness.
Dyspareunia and postcoital bleeding are common.
Well-demarcated erosion with erythematous patches and ulceration of the vulva and inner aspects of the labia minora (may precede oral lesions by years; 33% of patients). White striae or a serpentine, white border along the margins are common.
Loss of the labia minora with scarring, adhesions, and narrowing common (complete obliteration of the vagina possible).
Oral lesions—reticulated gray, lacy pattern (Wickham striae) with gingivitis (vulvar involvement in 50% of patients with oral lesions).
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