Isolated nail lichen planus: An expert consensus on treatment of the classical form

Matilde Iorizzo, Antonella Tosti, Michela Starace, Robert Baran, C. Ralph Daniel, Nilton Di Chiacchio, Sophie Goettmann, Chander Grover, Eckart Haneke, Shari R. Lipner, Phoebe Rich, Bertrand Richert, Dimitris Rigopoulos, Adam I. Rubin, Martin Zaiac, Bianca Maria Piraccini

Research output: Contribution to journalReview article

Abstract

Lichen planus is a benign inflammatory disorder of unknown etiology that may affect the skin, mucosae, scalp, and nails. When the nails are affected, it may lead to permanent destruction with severe functional and psychosocial consequences. Therefore, prompt diagnosis and early treatment are essential, even in mild cases. There are currently no guidelines for the management of nail lichen planus and the published literature on treatment is limited. The aim of this review is to provide practical management recommendations for the classical form of nail lichen planus, especially when restricted to the nails. Topical treatment has poor short-term efficacy and may cause long-term side effects. Instead, intralesional and intramuscular triamcinolone acetonide should be considered first-line therapies. Oral retinoids are second-line choices, and immunosuppressive agents may also be considered.

Original languageEnglish (US)
JournalJournal of the American Academy of Dermatology
DOIs
StateAccepted/In press - Jan 1 2020

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Keywords

  • acitretin
  • alitretinoin
  • consensus
  • guidelines
  • intralesional steroid injections
  • lichen planus
  • management
  • nail dystrophy
  • nail fissuring
  • nail lichen planus
  • nail ridging
  • retinoids
  • treatment
  • triamcinolone acetonide

ASJC Scopus subject areas

  • Dermatology

Cite this

Iorizzo, M., Tosti, A., Starace, M., Baran, R., Daniel, C. R., Di Chiacchio, N., Goettmann, S., Grover, C., Haneke, E., Lipner, S. R., Rich, P., Richert, B., Rigopoulos, D., Rubin, A. I., Zaiac, M., & Piraccini, B. M. (Accepted/In press). Isolated nail lichen planus: An expert consensus on treatment of the classical form. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2020.02.056