Oral lichen planus appears as white streaks in a lace-like pattern on the tongue and/or buccal mucosa. It is usually associated with purplish skin lesions on the body especially around the wrists and ankles. The oral lesions may be itchy, painful or asymptomatic. A biopsy is usually taken to confirm the diagnosis and to exclude malignant transformation. Oral lichen planus is treated with topical steroid gel.