Diagnosis: Lichen planus nails
Description: Ridging and discoloration of the nails.
Morphology: Nail dystrophy
Site: Nails
Sex: F
Age: 37
Type: Clinical
Submitted By: Nameer Al-Sudany
Differential DiagnosisHistory: A middle-aged housewife complaining of nail problem of more than one year duration. On examination, longitudinal nail ridging, discoloration and subungual hyperkeratosis were confined only to both thumbs' and big toes' nails. Tinea unguium was the main differential diagnosis, however symmetry of nail changes and negative KOH examination of nail clippings made lichen planus ranking the first diagnosis.