Lichen Planus

Specific nail involvement occurs in about 10% of patients with lichen planus and permanent damage of at least one nail occurs in approximately 4% of patients. However, if lichen planus is correctly diagnosed and treated, permanent damage to the nail unit is rare, even where there is diffuse involvement of the nail matrix.

Systemic steroids are effective in treating nail lichen planus: intramuscular triamcinolone acetonide 0.5 mg/kg every month for 2-3 months usually produces recovery of the nail abnormalities. Intralesional injections of triamcinolone acetonide

10mg/ml represent a possible, but painful, alternative when the disease is limited to a few finger nails. Mild relapses are frequently observed, but recurrences are usually responsive to therapy. Steroid treatment is not useful in pterygium, since the nail matrix cannot be regenerated. Systemic retinoids at dosages suitable for psoriasis are a good alternative.

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