He had otherwise been systemically well.

O/E:
Multiple violaceous papules coalescing into plaques over the wrists and ankles. Wickham's striae evident. No mucosal ulceration.

Dx:
Lichen Planus

Patient commenced on (usual protocol at this site):
•        Antihistamine (ebastine)
•        Salicylic acid (3%) + betamethasone [cream BD]
o         Plan to follow up at 2 weeks and escalate to clobetasol if not improving
•        Liquid paraffin

Lichen planus in coloured skin makes it more difficult to appreciate the violaceous colour of the lesions but it is still present.