Symptoms:

• Mouth lesions
  • Tender or painful (mild cases may have no discomfort)
  • Located on the sides of the tongue or the inside of the cheek
  • Occasionally located on the gums
  • Poorly defined area of blue-white spots or "pimples"
  • Lines of lesions that form a lacy-looking network
  • Gradual increase in size of the affected area
  • Lesions occasionally form painful ulcers
• Skin lesions:
  • Usually located on the inner wrist, legs, torso, or genitals
  • Itchy
  • Symmetrical
  • Single lesion or clusters of lesions, often at sites of skin trauma
  • Papule 2 - 4 cm in size
  • Papules clustered into a large, flat-topped lesion
  • Lesions have distinct, sharp borders
  • Possibly covered with fine white streaks or scratch marks called Wickham's striae
  • Shiny or scaly appearance
  • Dark colored -- reddish-purple (skin) or gray-white (mouth)
  • Possibility of developing blisters or ulcers

Other symptoms include:

• Dry mouth
• Hair loss
• Metallic taste in the mouth
• Ridges in the nails (nail abnormalities)

Signs and tests:

The health care provider may make the diagnosis based on the appearance of the skin or mouth lesions.

A skin lesion biopsy or biopsy of a mouth lesion can confirm the diagnosis. Blood tests may be done to rule out hepatitis.