Nail lichen planus: clinical and pathologic study of twenty-four patients.

BACKGROUND: We studied a large series of patients with lichen planus (LP) limited to the nails.

OBJECTIVE: Our purpose was to review the clinical and histopathologic features of 24 patients with LP limited to the nails and to discuss treatment and long-term prognosis.

METHODS: The records of 24 patients with biopsy-confirmed nail LP were analyzed. Clinical and follow-up data were obtained.

RESULTS: Nail LP usually appears during the fifth or sixth decade of life. Neither gender-associated susceptibility nor seasonal influences were detected. In most cases, nail LP is self-limiting or promptly regresses with treatment. Recurrences of nail lesions as well as development of LP in other regions of the body are possible. The development of severe and early destruction of the nail matrix characterizes a small subset of patients with nail LP.

CONCLUSION: Approximately 25% of patients with nail LP have LP in other sites before or after the onset of nail lesions. Long-term observation indicates that permanent damage to the nail is rare even in patients with diffuse involvement of the matrix.