This case was presented by Dr Khalil Alhamdi, Basrah Medical College, Iraq.
S.G, 62 yo woman, presented with bilateral itchy palms 2 years duration with poor response to treatment. Physical examination is normal apart from bilateral diffuse hyperkeratotic violaceous palms. All laboratory investigations were normal
Histopathology: histopathological examination showed typical features of lichen plaus.
Diagnosis: palmer lichen planus.
Histopathology: histopathological examination showed typical features of lichen plaus.
Diagnosis: palmer lichen planus.
What is the experience of our colleagues in seeing such a presentation of palmer lichen planus? comment please.
Isolated involvement of palms and soles by Lichen planus is rare. I have seen few cases in recent past where lesions were present in the form of well defined yellowish hypekeratotic nodules and plaques over palms/soles. Erythema is not so easy to appreciate over these sites unlike rest parts of the body. Most of these patients have involvement of other sites like oral, genital mucosa, skin or nails. LP over palms/soles is often resistant to treatment, Oral acitretin combined with topical potent steroids and keratolytics work fairly well. Abscence of fissuring and erythema and onset usually in middle age differentiate it from Psoriasis and Palmoplantar keratoderma.
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