Hello. Thanks for writing to us at healthcaremagic Lichen planus (LP) has an autoimmune etiology. It presents as itchy, polygonal, violacoeus or purple coloured, flat lesions. Itching is a prominent feature in lichen planus. Sites commonly affected are wrists, abdomen (flanks), shins, flexor arms. The disease may be localized or generalized. Oral mucosa as well as nail involvement may also be seen in LP. Oral lesions may cause eating and swallowing difficult. The diagnosis of LP is mostly clinical however a skin biopsy may be ordered to confirm the clinical diagnosis. Skin biopsy in LP is performed under local anaesthesia. You would be awake but you wont feel the pain. Topical treatment of lichen planus is with prescription topical superpotent steroids e,g clobetasol propionate cream OR Halobetasol propionate cream. These alone are sufficient for limited disease. In addition to topical steroids, oral steroids and hydroxychloroquin are also used in treatment of Lichen planus, specially when it is widespread. Lichen Planus has a good prognosis, the lesions ultimately subside but there may be a few recurrences before it finally subsides. Post-inflammatory hyperpigmentation may persist for months of years after LP has resolved. Regards