扁平苔藓 (LP) 是一种特发性、多方面的慢性炎症性疾病，具有异质性临床表现，影响大约 0.5-1% 的人口。 LP的各种临床表现可分为三大类，即皮肤、附件和粘膜，并根据单个病变的形态和分布模式进一步细分。越来越多的证据表明，LP 与全身相关，包括自身免疫性疾病、葡萄糖耐受不良、血脂异常和心血管疾病。皮肤肥厚型和粘膜型 LP 恶变的风险较高。熟悉这些潜在的关联，再加上长期随访和定期筛查，可以及时诊断和管理伴随病症。此外，腰椎病患者的生活质量 (QoL) 经常受损，这凸显了采取包括心理评估和支持在内的综合方法的必要性。人们已经尝试了几种治疗策略，但由于获益风险比不理想或缺乏证据，大多数策略尚未在临床实践中采用。最近针对发病机制驱动的治疗的研究已确定 Janus 激酶抑制剂（如托法替布）、磷酸二酯酶 4 抑制剂（如阿普斯特）和针对白细胞介素 23/白细胞介素 17 通路的生物制剂作为新的治疗选择，从而导致治疗方法发生巨大变化LP 的风景。本当代综述重点关注 LP 的诊断和治疗，并重点关注最近描述的靶向治疗方案。© 2024。作者获得 Springer Nature Switzerland AG 的独家许可。

Lichen planus (LP), an idiopathic, multifaceted chronic inflammatory disease with a heterogeneous clinical presentation, affects approximately 0.5-1% of the population. The various clinical manifestations of LP fall into three broad categories, namely cutaneous, appendageal, and mucosal, with further subclassification depending on the morphology and distribution patterns of individual lesions. There is mounting evidence that LP has systemic associations, including autoimmune conditions, glucose intolerance, dyslipidemia, and cardiovascular disorders. Cutaneous hypertrophic and mucosal forms of LP are at a heightened risk for malignant transformation. Familiarity with these potential associations in conjunction with long-term follow-up and regular screening could lead to a timely diagnosis and management of concomitant conditions. In addition, the frequent quality of life (QoL) impairment in LP underscores the need for a comprehensive approach including psychological evaluation and support. Several treatment strategies have been attempted, though most of them have not been adopted in clinical practice because of suboptimal benefit-to-risk ratios or lack of evidence. More recent studies toward pathogenesis-driven treatments have identified Janus kinase inhibitors such as tofacitinib, phosphodiesterase-4 inhibitors such as apremilast, and biologics targeting the interleukin-23/interleukin-17 pathway as novel therapeutic options, resulting in a dramatic change of the treatment landscape of LP. This contemporary review focuses on the diagnosis and management of LP, and places emphasis on more recently described targeted treatment options.© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.