Hypertrophic lichen planus in a 10-year old patient

ABSTRACT

We describe a case of a 10-year old female who consulted at our institution with plaques on the scalp, neck, trunk and extremities. The lesions were multiple, erythematous to violaceous, flat-topped papules and plaques with Wickham's striae. The nail involvement showed thinning of the nail plate, onycholysis, onychodystrophy, longitudinal ridging, and starting pterygium. Biopsy showed orthokeratosis, wedge-shaped hypergranulosis, irregular acanthosis and lichenoid pattern (mostly lymphocytes). Focal vacuolar alteration is also noted with few melanophages present and few Civatte bodies are noted. Negative HBsAg, anti-HBs and HCV were noted. The patient was treated with clobetasol dipropionate ointment,prednisone 10mg/day, oral antibiotic and antihistamine with marked clinical improvement after 2 weeks.