Lichen planus may rarely be localized to the nails.
Objective:
A case of ungual lichen planus is reported that was misdiagnosed as onychomycosis.
Methods:
A 52-year-old woman had progressive nail dystrophy for 13 months that was unresponsive to oral terbinafine. A nail biopsy was performed.
Results:
Histopathologic findings were consistent with lichen planus.
Conclusion:
Onychomycosis may be confused clinically with other causes of nail dystrophy. It is important to confirm the diagnosis of onychomycosis with appropriate laboratory or histologic analysis.
Get full access to this article
View all access options for this article.
References
1.
BlackMM. Lichen planus and lichenoid disorders. In: ChampionRHBurtonJLEblingFJG, eds. Rook/Wilkinson/Ebling: Textbook of dermatology. 5th Ed.Oxford: Blackwell Scientific, 1992:1675–1698.
2.
SammanPD. The nails in lichen planus. Br J Dermatol1961; 73:288–292.
3.
CorneliusCEShelleyWB. Permanent anonychia due to lichen planus. Arch Dermatol1967; 96:434–435.
4.
BurgoonCFJrKostrzewaRM. Lichen planus limited to the nails. Arch Dermatol1969; 100:371.
5.
MarksRSammanPD. Isolated nail dystrophy due to lichen planus. Trans St Johns Hosp Dermatol Soc1972; 58:93–97.
6.
ScottMJJrScottMJ. Ungual lichen planus: Lichen planus of the nail. Arch Dermatol1979; 115:1197–1199.
7.
KanwarAJGovilDCSinghOP. Lichen planus limited to the nails. Cutis1983; 32:163–164, 168.
8.
OlivaNPVaqueroEV. Lichen planus of the nails. Cutis1993; 52:171–172.
9.
TostiAPelusoAMFantiPA. Nail lichen planus: Clinical and pathologic study of twenty-four patients. J Am Acad Dermatol1993; 28:724–730.
10.
RoncheseF. Nail in lichen planus. Arch Dermatol1965; 91:347–350.
11.
ZaiasN. The nail in lichen planus. Arch Dermatol1970; 101:264–271.
12.
Del RossoJQBasukPJScherRK. Dermatologic diseases of the nail unit. In: ScherRKDanielCR, eds. Nails: Therapy, diagnosis, surgery. 2nd Ed.Philadelphia: WB Saunders, 1997:184–188.
13.
ScherRKFischbeinRAckermanAB. Twenty-nail dystrophy: A variant of lichen planus. Arch Dermatol1978; 114:612–613.
14.
SilvermanRARhodesAR. Twenty-nail dystrophy of childhood: A sign of localized lichen planus. Pediatr Dermatol1984; 3:207–210.
15.
TostiABardazziFPiracciniBM. Idiopathic trachyony-chia (twenty-nail dystrophy): A pathological study of 23 patients. Br J Dermatol1994; 131:866–872.
16.
SowdenJMCartwrightPHGreenJRB. Isolated lichen planus of the nails associated with primary biliary cirrhosis. Br J Dermatol1989; 121:659–662.
17.
HanekeEBaranR. Nail surgery and traumatic abnormalities. In: Diseases of the nails and their management. 2nd Ed.Blackwell Scientific, 1994:345–364.
LaurbergGGeigerJMHjorthN. Treatment of lichen planus with acitretin. J Am Acad Dermatol1991; 24:434–437.
20.
KatoNUenoH. Isolated lichen planus of the nails treated with etretinate. J Dermatol1993; 20:577–580.
21.
GonzálezEMomtazT-KFreedmanS. Bilateral comparison of generalized lichen planus treated with psoralens and ultraviolet A. J Am Acad Dermatol1994; 10:958–961.
22.
KerscherMVolkenandtMLehmannP. PUVA-bath photochemotherapy of lichen planus [Letter]. Arch Dermatol1995; 131:1210–1211.
SehgalVNAbrahamGJSMalikGB. Griseofulvin therapy in lichen planus: A double-blind controlled trial. Br J Dermatol1972; 87:383–385.
25.
SehgalVNBikhchandaniRKoranneRV. Histopathological evaluation of griseofulvin therapy in lichen planus: A double-blind controlled study. Dermatologica1980; 161:22–27.
