LICHEN-PLANUS LIMITED TO THE NAILS IN CHILDHOOD - CASE-REPORT AND LITERATURE-REVIEW

Although nail abnormalities have been reported to occur in 1% to 10% o f patients with lichen planus, in children with lichen planus they are rarely mentioned in the literature. An 11-year-old boy had a two-mont h history of nail dystrophy affecting all the fingernails and the grea t toenails. The nail plates showed longitudinal ridging and thinning a s well as onycholysis and distal splitting. There were no cutaneous or mucous membrane abnormalities. A nail biopsy specimen showed hyperker atosis, hypergranulosis, and acanthosis in the ventral portion of the proximal nail fold and in the nail matrix. A bandlike lymphocytic infi ltrate was present in the superficial dermis, and the basal layer show ed vacuolar alterations. A diagnosis of lichen planus was made. Treatm ent was intramuscular triamcinolone 20 mg once a month for six months. Since 1969 only 13 proved pediatric cases of lichen planus limited to the nails have been reported, including two children with 20-nail dys trophy and four with idiopathic atrophy of the nails.