Medical dermatology
Lichen Planus
An immune-mediated condition causing purple, itchy skin lesions and oral sores — diagnosed and managed by expert dermatologists in Miami.
Classic Features
- Skin: flat, purple, polygonal, pruritic papules — often on wrists, ankles, lower back
- Oral: reticular white patches (Wickham striae) or erosive lesions on gums and inner cheeks
- Nails: ridging, thinning, and pterygium formation
- Scalp (lichen planopilaris): follicular inflammation leading to scarring alopecia
Causes
The exact trigger is unknown, but T-cell-mediated immune attack on keratinocytes is central. Associations include hepatitis C virus infection, certain medications (thiazides, NSAIDs, antimalarials), and dental amalgam.
Treatment
- Topical: high-potency corticosteroids (clobetasol), tacrolimus for oral/genital lesions
- Intralesional: triamcinolone for hypertrophic variants
- Systemic: hydroxychloroquine, acitretin, cyclosporine, mycophenolate mofetil
- Phototherapy: narrowband UVB for widespread cutaneous disease
Monitoring
Erosive oral lichen planus carries a small risk (< 1%) of oral squamous cell carcinoma; regular follow-up is essential.
Frequently asked questions
Is lichen planus contagious?
Can lichen planus be cured?
Most insurance plans cover medical dermatology procedures. Contact us to verify your benefits.
Trusted sources
This page is educational. Specific treatment decisions are made during your visit with Dr. Puyana.
Related procedures

Skin Cancer Screening
A head-to-toe full-body skin exam with a board-certified dermatologist — the single best thing you can do for skin cancer prevention in South Florida.
Learn more
Acne Treatment
A personalized acne plan from a dermatologist — not a generic over-the-counter routine. Clearer skin in 8–12 weeks for most patients.
Learn more
Eczema (Atopic Dermatitis)
Modern eczema care goes far beyond steroid creams — biologics and JAK inhibitors mean most patients can finally have calm skin year-round.
Learn moreBefore & After
Real patient results from Miami Skin Center.
Book a consultation
Tell us a little about what you need. Our team responds in the language you choose.