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Scher and Daniel’s Nails pp 127–143Cite as

Nail Unit Lichen Planus

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Abstract

Nail abnormalities are seen in approximately 10% of adult patients with cutaneous lichen planus, but in most of the cases nail LP is not associated with skin or mucosal lesions, a mild oral LP being detected in less then one-fourth of the patients only after examination. Most commonly, nail LP involves the nail matrix and presents with nail thinning with longitudinal ridging and fissuring (onychorrhexis) that usually involve several-all nails. Dorsal pterygium is a possible outcome and indicates focal scarring of the nail matrix. Unless the patient has clinical signs of LP of the skin of mucosae, diagnosis of nail LP requires a biopsy, as the differential diagnosis is not always easy clinically. Moreover, as treatment of nail LP requires systemic or intralesional drugs, in order to avoid permanent scarring, having a pathological confirmation of the diagnosis helps to increase patient’s acceptance of therapy. Treatment of nail LP is difficult, as not all patients respond to therapy. Optimal therapy is still lacking, and systemic or intralesional steroids (the choice is based on the numbers of nails involved) are the treatment of choice.

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Author information

Authors and Affiliations

  1. Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy

    Bianca Maria Piraccini, Michela Starace, Cosimo Misciali & Pier Alessandro Fanti

Authors
  1. Bianca Maria Piraccini
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  2. Michela Starace
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  3. Cosimo Misciali
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  4. Pier Alessandro Fanti
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Corresponding author

Correspondence to Bianca Maria Piraccini .

Editor information

Editors and Affiliations

  1. University of Pennsylvania, Philadelphia, PA, USA

    Adam I. Rubin

  2. Brown University, Providence, RI, USA

    Nathaniel J. Jellinek

  3. Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, USA

    C. Ralph Daniel III

  4. Department of Dermatology, Weill Cornell Medical College, New York, NY, USA

    Richard K. Scher

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Piraccini, B.M., Starace, M., Misciali, C., Fanti, P.A. (2018). Nail Unit Lichen Planus. In: Rubin, A.I., Jellinek, N.J., Daniel, C.R., Scher, R.K. (eds) Scher and Daniel’s Nails. Springer, Cham. https://doi.org/10.1007/978-3-319-65649-6_7

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  • DOI: https://doi.org/10.1007/978-3-319-65649-6_7

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65647-2

  • Online ISBN: 978-3-319-65649-6

  • eBook Packages: MedicineMedicine (R0)

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