In Episode 23, we break down lichen planus from the classic presentation to its many variations including cutaneous, oral, genital, scalp/lichen planopilaris, nail, hypertrophic, actinic, and pigmentosus so you can recognize patterns quickly, confirm the diagnosis when it’s subtle, and avoid common look-alikes. We also address the clinical reality that there is no FDA-approved treatment specifically for lichen planus, and walk through how clinicians build practical, stepwise management plans focused on symptom control, inflammation reduction, and preventing flares—plus how to counsel patients on expectations. Finally, we connect the dots on errors in metabolism and metabolic derangements that can complicate inflammatory skin disease and influence your differential, workup, and long-term strategy—so you’re not just treating the eruption, you’re treating the whole patient.