A young female presented with lacy linear lesions on buccal mucosa since a month with elongation of nail fold beyond the nail bed. What is the diagnosis -
As per the clinical picture, features such as forward growth of nail fold beyond nailbed ( pterygium) and lacy linear lesions on tongue points towards lichen planus. LICHEN PLANUS:-Inflammatory T cell mediated auto immune disorder affecting skin, hair,nails and mucous membranes.Four Ps- purple , polygonal and pruritic papule. Nail finding:-thinning , longitudinal ridging, and distal splitting of nail plate. Pterygium/ forward growth of the proximal nailfold with adherence to the proximal nail plate is a classic sign. Mucosal lichen planus:-Reticular pattern.- Lacy white pattern on buccal mucosa- whitish streaks IADVL textbook of dermatology page 1074
Psoriasis
Geographic tongue
Lichen planus
Candidiasis
Papulosquamous disorders