Palmar and plantar lichen planus: a case report and review of the literature

Abstract

Palmoplantar lichen planus is an uncommon dermatosis. We present a case of 38-year-old Caucasian male with a history of pruritic, scaly lesions on the right plantar foot. Physical examination revealed whitish plaques and numerous spiny hyperkeratotic papules and focal scaling. A biopsy demonstrated orthohyperkeratosis and acanthosis of the epidermis. Immunohistochemical staining revealed positivity within the epidermis and/or lichenoid infiltrate with CD3, CD8, CD45, CD68, myeloid histiod antigen, BCL2, p27, p53, HLA-DPDQDR, metallothionein and tissue inhibitor of metalloproteinases 1. The diagnosis of PPLP was thus confirmed; this case illustrates that PPLP should be considered in the differential diagnosis of uncommon foot dermatoses with a significant junctional inflammatory component.

Differential metallothionein expression in oral lichen planus and amalgam-associated oral lichenoid lesions

“…In the present study, we observed that MT expression is mainly observed in basal and parabasal layers of the oral epithelium, as previously described ( 11 , 19 , 20 ). In 1992, Hanada and collaborators explained that reactivity for MT in cutaneous lesions of lichen planus was concentrated in the granular layer of the epidermis, in the same way of healthy skin, but was less evident in the former ( 10 ).…”

“…In 1998, Matsuura, Tsukifuji, and Shinkai described MT expression in idiopathic annular lichen planus of the skin where MT immune staining increased as well, but it was discontinuous around the rim of erythema and undetectable in the center of the lesion ( 19 ). Other authors had depicted MT positivity in lower areas of the epidermis in one case of Palmoplantar lichen planus ( 20 ).…”

A case of palmoplantar lichen planus

“…PPLP may have multiple clinical presentations. While the erythematous scaly form with or with out hyperkeratosis is the most common, vesicular, petechiea -like, umblicated, pigmented macular,and ulcerative forms may also be observed [3]. While PPLP may be presentonly on the palms and/ or soles, it may also be associated LP lesions on the other sites including mucosa land nail involvement in some patients [6].Our patient also had lesions on the dorsum of the hands.…”

“…Sir, Lichenplanus (LP) is an idiopathic, inflammatory skin disease which may occur in various location sand morphologies [1]. Palmoplantar lichen planus (PPLP) is an uncommon, localized variant of LP which shows atypical clinical features [2,3]. PPLP presents classically with pruritic, erythematous, scaly and/orhyperkeratotoic plaques with welldefinededges [3].…”

“…However parakeratosis, which is not a classical feature of classical LP has been described over half of the cases in a case series [7]. PPLP might be difficult to diagnose as it resembles many dermatoses that involvespalmoplantarareasincluding psoriasis,tineamanum/pedis,keratoderma, dyshidrotic eczema, mycosis fungoides, verruca vulgaris, and secondary syphilis [2,3].The duration of the lesion sranges between 1 month and 8 years with the avarage of 11 months [6]. PPLP may be resistant to treatment and topical and intralesional corticosteroids, acitretin, tacrolimus, tazarotene, cyclosporine, methotrexate and dapson have been used with variable results in the treatment [4,5,7].…”