Keratosis Lichenoides Chronica with Pachyonychia Congenita-like Nail Changes

ABSTRACT

A 26-year-old man presented with a 7-month history of hyperkeratotic skin lesions on both elbows and heels. He also had marked subungal hyperkeratosis and splinter hemorrhage on the finger and toe nails. A biopsy specimen from the elbow revealed lichenoid re-actions with areas of epidermal atrophy with alternating acanthosis and foci of parakeratosis. We made a diagnosis of keratosis lichenoides chronica based on the characteristic clinicopathologic findings. We have treated the patient with etretinate, but only the skin lesions on the elbows and heels responded to treatment.