Palmoplantar Lichen Planus: A diagnosis to keep in mind
Journal Title: Sultan Qaboos University Medical Journal - Year 2019, Vol 19, Issue 1
Abstract
A29-year-old caucasian female patient was referred to the Dermatology Outpatient Clinic of Hospital Universitario San Cecilio, Granada, Spain in 2018 with a pruriginous palmoplantar eruption over the previous fve months that had not improved with the application of high-potency topical corticosteroids. She had no personal or family history of skin diseases. Recently, she denied the use of any medications. Dermatological examination revealed the presence of a well-defned diffuse erythema on the palm of the hands that spared the fngertips and bilateral violaceous polygonal papules on the dorsum aspect of the hands [Figures 1A & B]. On the soles of her feet, well-defned erythematous patches sparing the plantar arch were observed [Figure 1C]. No involvement of other skin areas or mucosa was noted. Laboratory tests including complete blood count, general biochemistry, venereal research laboratory tests, hepatitis B and C and HIV serology showed normal results. In addition, an allergic contact dermatitis patch test was negative. Histolopathologic examination of a lesion on the dorsum of the right hand revealed orthokeratotic hyperkeratosis, irregular acanthosis, vacuolar degeneration of the basal layer and band-like lymphocytic infltration on the papillary dermis [Figure 2]. Terefore, the patient was diagnosed with palmoplantar lichen planus (PPLP). Treatment with isotretinoin was proposed at a dose of 0.5 mg/kg/day with a substantial improvement three months later. At present, the patient remains asymptomatic with periodic consultations. Psoralen and ultraviolet A (PUVA) therapy for localised disease was refused by the patient for her inability to attend due to work-related reasons.
Authors and Affiliations
Ricardo Ruiz-Villaverde, Beatriz Rueda-Villafranca, Marina R. Galvez-Moreno
Keywords
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- EP ID EP43106
- DOI http://dx.doi.org/10.18295/squmj.2019.19.01.016
- Views 312
- Downloads 0
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