Dermatoscopy of Nail Lichen Planus: A Boon for Early Diagnosis.

Background: Lichen planus is an immune-mediated disorder affecting the skin, mucous membranes, scalp, and nails.

Objective: We sought to evaluate dermatoscopic nail patterns in patients with lichen planus.

Methods: This was a cross-sectional, observational study performed in the outpatient dermatology department of a tertiary care hospital. Thirty-one patients with skin biopsy-proven lichen planus with nail changes were included. An evaluation of clinical nail patterns and dermoscopic assessment of nail patterns were performed.

Results: Longitudinal ridging with splitting, longitudinal melanonychia and splinter hemorrhages were the most commonly found nail patterns in patients with lichen planus. Pterygium has been found to be most pathognomic feature of nail lichen planus.

Conclusion: Dermatoscopy has been demonstrated to be a valuable, noninvasive tool to identify subsurface nail bed changes and subclinical surface findings to facilitate early diagnosis and timely management of lichen planus to avoid long-term sequelae.