Since when have you been suffering ? WeeksMonthsYears
Is there a family history of lichen planus ? YesNoNot Sure
Has the lichen planus been increasing over a period of time ? YesNoNot Sure
Are your hands and legs affected with Lichen planus ? YesNo
Are your palms and soles affected with lichen planus ? YesNoOccasionally
Are there cracks/dryness in your palms and soles YesNo
Does your problem increase during winter ? YesNoNot Sure
Does the problem increase with stress ? YesNoNot Sure
Is there any itching in the affected region ? YesNoOccasionally
Is there any black discoloration in the affected region ? YesNoOccasionally
Is there any scaling in the affected region ? YesNoOccasionally
Is there any dandruff present ? YesNoOccasionally
Lots of stress in life YesNoOccasionally
Are your nails discolored or disfigured ? YesNoOccasionally
Have you got any investigations done? (If yes, then please mention the details of the results in the 'more symptoms' column) YesNo
Name:
Email Address:
Contact Number:
Location/City:
Gender:MaleFemale
Age:-Select-1 Month2 Months3 Months4 Months5 Months6 Months7 Months8 Months9 Months10 Months11 Months12 Months234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071727374757677787980818283848586878889909192939495969798
More Symptoms: