Clinical, Dermoscopic and Histopathological Characteristics of Lichen Planus: A Cross-sectional Study

Introduction: Lichen Planus (LP) is a common papulosquamous disorder encountered in Dermatology Outpatient Departments. It exhibits characteristic dermoscopic and histopathological features. Dermoscopy serves as a non invasive bridge between clinical diagnosis and histopathological confirmation. Aim: To describe the dermoscopic, clinical and histopathological features of LP and its variants. Materials and Methods: This cross-sectional study was conducted at the Department of Dermatology, Venereology and Leprosy at Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, India, from December 2023 to May 2025. Adult patients (>18 years) with clinically diagnosed LP were included in the study. A detailed history and clinical examination was done, and findings were recorded in predesigned proforma. This was followed by dermoscopy and histopathological examination, and findings were noted. The data was analysed using descriptive statistics, including frequency, percentage, mean, and standard deviation. Results: A total of 100 patients were enrolled, out of which 43 were males, and 57 females with a ratio of 1:1.3. Majority patients (n=56) were in age group 18-40 years 56 (56%). The duration of disease commonly seen was between three to six months 37 (37%). The most common site of involvement was the lower limbs, seen in 72 (72%) patients. The most common variant of LP seen was classical LP 65 (65%) followed by hypertrophic LP 12 (12%) and LP pigmentosus 7 (7%). On dermoscopic examination, Wickham’s striae was the most specific and sensitive finding found in 75 (75%) patients with reticular 25 (25%) being the most common morphological pattern. On histopathology, basal cell degeneration with bandlike infiltrate was found as most frequent finding 92 (92%) while wedge-shaped hypergranulosis 75 (75%) was most specific finding. Conclusion: Dermoscopic findings are specific for LP and, many times, can replace histopathology for diagnosis of the condition.