Pistachio nut shell as a nail substitute to improve function in patients with nail lichen planus

Abstract

Lichen planus is a chronic inflammatory disorder that may affect the skin, scalp, mucosa, and nails. Nail lichen planus (NLP) presents with longitudinal ridging and nail plate atrophy and splitting. With progressive disease, irreversible nail changes, including dorsal pterygium and anonychia ensue, make NLP a true nail emergency that requires prompt and aggressive treatment (Lipner, 2019). Diagnostic difficulties, prolonged periods without treatments, and high recurrence rates even with effective therapy contribute to the development of anonychia and pterygium in patients with NLP (Iorizzo et al., 2020). Tasks such as buttoning a shirt, picking up a coin, and manipulating fine tools become challenging, if not impossible, once the nail undergoes scarring or is permanently lost.