Hyperkeratotic Palmoplantar Lichen Planus in a child

Area of Science:

• Dermatology
• Pediatric Dermatology
• Inflammatory Disorders

Background:

• Lichen planus (LP) is a common idiopathic inflammatory disorder.
• LP typically affects wrists, legs, oral, and genital mucosa, with specific types including mucosal, nail, scalp, and palmoplantar.
• Palmoplantar LP presents diagnostic challenges due to its resemblance to other dermatoses.

Purpose of the Study:

• To report a rare case of childhood lichen planus with palmoplantar involvement.
• To emphasize the diagnostic considerations for palmoplantar LP in pediatric patients.

Main Methods:

• Case report of a 4-year-old male child.
• Clinical presentation: pruritic erythematous to violaceous hyperkeratotic papules and plaques on palms and soles, with typical LP papules on the upper back.
• Diagnostic tools: Histopathology of lesions and dermatoscopy.

Main Results:

• Histopathology confirmed features of lichen planus.
• Dermatoscopy revealed characteristic Wickham striae on a papule from the back.
• The patient presented with rare palm and sole involvement in childhood LP.

Conclusions:

• Childhood lichen planus can manifest with rare palmoplantar involvement.
• Accurate diagnosis of palmoplantar LP requires careful clinical evaluation and histopathological confirmation.
• This case underscores the importance of considering LP in the differential diagnosis of pediatric palmoplantar dermatoses.