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Rough nails with reticulate oral lesions
How to cite this article: Narayanan A, Ramar SY. Rough nails with reticulate oral lesions. CosmoDerma 2022;2:18.
A 35-year-old male patient presented with dystrophy of all 10 fingernails. The patient had brittle, thin nails with increased longitudinal ridging [Figure 1a] resulting in a rough, opaque appearance for 6 months. The patient had nontender, reticulate white lesions on his bilateral buccal mucosa [Figure 1b]. Based on the characteristic clinical appearance, we made a diagnosis of trachyonychia secondary to nail lichen planus (LP) with oral lichen planus. Trachyonychia is a disorder of the nail matrix seen in 10% of patients with nail LP. While nail LP is most often isolated in these patients, the most common type of LP associated with nail LP is oral LP. Treatment is often challenging, and treatment options include topical clobetasol propionate, intramatricial triamcinolone, tazarotene gel, systemic retinoids, and cyclosporine.
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