Generalized Lichen Planus: A Case Report

Abstract

Generalized lichen planus commonly presented with violaceous papules and plaques on trunk and extremities. Before establishing the diagnosis, drug-induced lichenoid eruption must be excluded. Some cases have mucosal involvement. Palmoplantar involvement of lichen planus is uncommon and underdiagnosed. Common clinical findings are scaly erythematous or hyperkeratotic plaques with well-defined edges on the instep, edge of the feet, thenar and hypothenar eminences, and center of the palms. The fingertips are rarely involved. The differential diagnosis of palmoplantar lesions included psoriasis, tinea manuum and tinea pedis, eczematous contact dermatitis, and syphilis. We report a patient with cutaneous and mucosal lichenoid lesions, as well as palmoplantar lesions which was not associated with medication used. Histopathology from skin lesion was consistent with lichen planus without eosinophil infiltration. The diagnosis of lichen planus with palmoplantar involvement was established. However, differential diagnosis of palmoplantar psoriasis should be concerned. Therefore, it is important to recognize these clinical presentations of lichen planus to establish early diagnosis and treatment.