Use of Etanercept in the Treatment of Moderate to Severe Lichen Planus

Inclusion Criteria: * At least 18 years old. * Must carry a diagnosis of lichen planus as determined by biopsy * Patients must have a score of 3 or greater on the physician global assessment (PGA). * Patient must be considered appropriate for systemic therapy based upon fulfilling one of the following criteria: 1. inability to maintain weight due to pain with eating, chewing, or swallowing; 2. dyspareunia or dysuria due to genital lesions; 3. itch/pain of sufficient severity that activities of daily living are significantly affected * Must be off systemic lichen planus treatment for 4 weeks prior to starting etanercept * If using topical corticosteroid to the affected areas, the dose and frequency must be unchanged for 2 weeks prior to beginning the study agent and during the course of the study. * Must be off topical cyclosporine, tacrolimus, or pimecrolimus for 2 weeks prior to starting the study drug and for the entire duration of the study. * Must be able and willing to give written informed consent and comply with the requirements of the study protocol and must authorize release and use of protected health information. * Women of childbearing potential must have a negative pregnancy test at the time of entry into the study and must be practicing successful contraception for at least 3 months prior to the study. * Subject or designee must have the ability to self-inject investigational product. * Screening laboratory results are within the following parameters: * Hemoglobin \> 10 g/dL * White blood cells \> 3.5 x 10\^9/L * Neutrophils \> 1.5 x 10\^9/L * Platelets \> 100 x 10\^9/L * Lymphocytes \> 0.5 x 10\^9/L * Serum creatinine \< 1.5 mg/dL * Hepatitis C serology - nonreactive * AST and ALT \< 2X upper limit of normal (ULN) Exclusion Criteria: * Subject is currently enrolled in another investigational device or drug trial(s), or subject has received investigational agent(s) within 90 days of baseline visit. * Known HIV-positive status, any other immuno-suppressive disease, or inability to practice safe sex during the length of the study * Subject has been diagnosed with a malignancy within the past 5 years * Subject has signs or symptoms of a lymphoproliferative disease. * Other skin or mucosal disease that might interfere with lichen planus assessments. * Lichen planus variants including hypertrophic, atrophic, follicular (including lichen planopilaris), and bullous cutaneous forms. * Patients with lichen sclerosis et atrophicus (LS\&A) * Clinical history and lesion distribution suspicious for a lichenoid drug eruption * Severe co-morbidities * History of tuberculosis (TB) or positive PPD at screening. Known history of active hepatitis B or C, or lupus, SLE, history of multiple sclerosis or prior episode of central nervous system demyelination, transverse myelitis, optic neuritis, epilepsy, psychiatric condition, or other chronic serious medical illnesses. * Subject has a diagnosis of congestive heart failure (CHF) of any severity * Use of a live vaccine 90 days prior to, or during this study. * Previous exposure and/or known sensitivity to etanercept * Concurrent use, or failure of, any TNF-inhibitor * Previous exposure to alefacept or efalizumab within 6 weeks of administration of study drug * Concurrent sulfasalazine therapy * Prior or concurrent cyclophosphamide therapy * Active severe infections, or prior infection requiring hospitalization or oral/intravenous antibiotics within 4 weeks before screening visit, or between the screening and baseline visits. * Active inflammatory bowel disease or peptic ulcer disease * Drug or alcohol abuse within 12 months of screening visit. * History of non-compliance with other therapies * Pregnant or lactating * Documented presence of any of the following: * Proteinuria \> 1+ by dipstick screening * 24 Hour protein excretion \> 0.5 g * Symptomatic liver disease with serum albumin \< 3 G/DL * PT or PTT \> ULN, or * Chronic liver disease * Documented forced vital capacity \< 50% of predicted