Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • pruritus
  • violaceous, flat-topped papules or plaques
  • Wickham's striae
  • mucosal erosions and lacy white network
  • scarring alopecia
  • nail involvement

Other diagnostic factors

  • dorsal pterygium
  • history of hepatitis C (HCV)

Risk factors

  • hepatitis C (in some patient populations)
  • -308 G/A polymorphism in TNF-alpha gene
  • hepatitis B vaccination
  • influenza vaccination
  • psychosocial stress
  • oral allergens

Diagnostic investigations

Investigations to consider

  • histopathology
  • hepatitis C (HCV) screen
  • immunofluorescence
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Dermatologist

Dermatology

Oxford University Hospitals Foundation Trust

Honorary Senior Clinical Lecturer

University of Oxford

Oxford

UK

Disclosures

SC is chair of the British Society for the Study of Vulval Disease and receives royalties for contributions to UpToDate.

Consultant Dermatologist

Department of Dermatology

Polonnaruwa General Hospital

Polonnaruwa

Sri Lanka

Disclosures

DM declares that she has no competing interests.

Dr Susan Cooper and Dr Deepani Munidasa would like to gratefully acknowledge Dr Rebecca Dunn, Dr Julia S. Lehman, Dr Megha M. Tollefson, and Dr Lawrence E. Gibson, previous contributors to this monograph. RD, JSL, MMT, and LEG declare that they have no competing interests.

Peer reviewers VIEW ALL

Clinical Assistant Professor

University of Iowa College of Medicine

Iowa City

IA

Disclosures

BS declares that he has no competing interests.

Assistant Professor

Department of Pathology and Laboratory Medicine

University of California

Los Angeles

CA

Disclosures

DC declares that he has no competing interests.

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