Nail lichen planus: a patient with atypical presentation

Abstract

Lichen planus is a common disease affecting up to 1% of the population. Lichen planus is a chronic inflammatory dermatosis with characteristic clinical and histopathological features. Classic lichen planus typically characterized by small, violaceous, flattopped polygonal papules mostly seen on the flexural wrists and ankles. A unique feature of lichen planus is superimposed, lacy, reticular pattern of crisscrossed whitish lines, termed “Wickham’s striae”, of which visualization is accentuated by application of a drop of immersion oil. Other than classic lichen planus, several variants of lichen planus, which differ in morphology and localization have been described. Moreover, lichen planus is a particular disease, in which mucosal or nail involvement may develop in the absence of cutaneous lesions. Although several nail changes are observed in lichen planus, one of the most distinguishing nail finding is the formation of dorsal pterygium [1-3]. Here, we report a case with dorsal pterygium, who also manifests atypical mucosal and cutaneous lesions. CASE REPORT