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Case of the Month With Crutchfield Dermatology
lace-like pattern on the surface, known as Wickham's striae. Some cases have been associated with
Diagnosis: Lichen Planus Lichen Planus is an idiopathic papulo-
squamous disorder producing violaceous papules that most commonly occur on the wrists and ankles. Some call it the 'P' disease because the lesions are purple, pruritic, polished (shiny on the surface), polygonal in shape, papular, puzzling (idiopathic) and problematic (difficult to treat). They often have a white,
hepatitis, so a hepatitis screen is always appropriate. Some cases have been associated with medication reactions and others associated with the ingestion of gold (as found in some liquors). The lesions are generally reported to be
very pruritic, but, rarely, excoriations are observed. Patients report rubbing, rather than scratching, feels better. When oral lesions are present, advise the patient to avoid ethanol and tobacco to reduce chances of developing oral carcinoma. There are other variants of the disease that can occur on the nails and mimic
fungal infections, a scarring alopecia on the scalp (lichen planopilaris), oral variants (ulcers and reticulated in the mouth = Wickham's striae), a hypertrophic variant that occurs on he lower extremities, and an atrophic or flat variant that occurs in the axilla, forehead and genitals. Treatment is best achieved with
topical CutiCort Spray and narrowband ultraviolet B light treatments. Untreated cases may run their course in months to years.
For more informat ion, contact
Charles E. Crutchf ield III, M.D., at Crutchf ield Dermatolog y or vi s i t www.CrutchfieldDermatology.com. ■
6 | Twin Cities MD NEWS ■ MDNEWS.COM
