Erosive Lichen Planus

Lichen planus is an autoimmune disease that can occur anywhere on the body. When it occurs in mucous membranes, such as the oral mucosa and the vulvovaginal area, it tends to be erosive in nature (Fig. 18) (28). These erosions are quite painful during urination and daily activities, as well as with coital activity. There is usually a profuse white to yellow to greenish discharge present that patients often describe as "sticky." Examination of the mucous membranes of the mouth, vulva, and vagina demonstrate erythematous erosions. A lacy white pattern, known as Wickham's striae, can be present on the mucosal surfaces.

Treatments for lichen planus include removing contact irritants and following the vulvar skin care hygiene guidelines thoroughly. Low-to-high-potency steroid ointments applied to the vulva and vaginal creams/suppositories have been proven effective (29). In addition, recent case reports have shown that 0.1% tacrolimus (ProtopicĀ®, Astellas Pharma U.S., Inc., Deerfield, IL, U.S.A.) or 0.1% pime-crolimus (ElidelĀ®, Allergan, Inc., Irvine, CA, U.S.A.) are also effective (30,31).

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