CASE REPORTS   

Esperienze Dermatologiche 2014 March;16(1):9-12

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English, Italian

Palmar lichen planus: an unusual localization

Savoia F. ^{1, 2}, Gaddoni G. ¹, Odorici G. ², Tengattini V. ², Misciali C. ², Raone B. ², Patrizi A. ², Sgubbi P. ²

¹ Dermatology Unit, AUSL Ravenna, Ravenna, Italy; ² Dermatology Unit, Department of Specialised, Experimental and Diagnostic Medicine, S. Orsola-Malpighi Hospital, Università di Bologna, Bologna, Italy

We report an unusual case of lichen planus with only palmar involvement, clinically characterized by well-circumscribed areas of hyperkeratosis on an erythemato-violaceous background, localized on both the palms. The disease was resistant to different topical potent steroids, tazarotene 0.1% gel and oral metronidazole. Complete healing was obtained with topical PUVA therapy. Our case points out the utility of histology in uncertain cases of palmar keratoderma and confirms that PUVA therapy is still an effective treatment for lichen planus, including palmar lichen planus. On the other hand, oral metronidazole, that was recently proposed as an alternative therapy in the treatment of cutaneous and mucosal lichen planus, did not show any efficacy in our patient.