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An Old Lady With Scarring Alopecia and an Ulcerated Sole

An Old Lady With Scarring Alopecia and an Ulcerated Sole Abstract REPORT OF A CASE A 76-year-old woman reported that erythematous bullous lesions had occurred on both of her big toes in the periungual area 20 years earlier. The lesions caused the nail plates to detach progressively and fall off eventually. Simultaneously, she noticed a large area of alopecia on her scalp. Three years before presenting to the clinic, after removing a plaster cast that had been applied to treat a fracture of the internal right malleolus, an ulcer developed on her right sole. Over the ensuing 3 years, the size of the lesion increased continuously and bullae developed occasionally, accompanied by sensations of burning and itching.On examination of her scalp, there was a large area of scarring alopecia on the vertex, with neither erythema nor follicular hyperkeratosis (Fig 1). The nails of both of her big toes were absent, and atrophy of the nail bed and matrix was noted References 1. Cram DL, Kierlana RR, Winkelmann RK. Ulcerative lichen planus of the feet: bullous variant with hair and nail lesions . Arch Dermatol. 1966;93:692-701.Crossref 2. Degos MMR, Delort J, Belaich S, Schnitzler L. Lichen plan érosif du pied: nouveau cas . Bull Soc Fr Dermaol Syphilol. 1966;73:844-846. 3. Gardner RK, Johnson HH, Binkley GW. Bullous lichen planus with onychatrophy . Arch Dermatol. 1955;71:636-637.Crossref 4. Altman J, Perry HO. The variations and course of lichen planus . Arch Dermatol. 1961;84:47-59.Crossref 5. Sarkany I. Atrophic lichen planus . Br J Dermatol. 1963;75:442-444. 6. Crotty CP, Daniel Su WP, Winkelmann RK. Ulcerative lichen planus: follow-up of surgical excision and grafting . Arch Dermatol. 1980;116:1252-1256.Crossref 7. Degos MMR, Desablet M, Chérif-Cheikh JL, Schnitzler L. Lichen érosìf des orteiles avec lichen érosìf buccal et vulvaire . Bull Soc Fr Dermatol Syphilol. 1967;74:718. 8. Zijdenbos LM, Starink TM, Spronk CA. Ulcerative lichen planus with associated sicca syndrome and good therapeutic result of skin grafting . J Am Acad Dermatol. 1985;13:667-668.Crossref 9. Rebora A. Lichen planus and the liver . Lancet . 1981;2:805-806.Crossref 10. Falk DK, Latour DL, King EL. Dapsone in the treatment of erosive lichen planus . J Am Acad Dermatol. 1985;12:567-570.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

An Old Lady With Scarring Alopecia and an Ulcerated Sole

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680030131022
Publisher site
See Article on Publisher Site

Abstract

Abstract REPORT OF A CASE A 76-year-old woman reported that erythematous bullous lesions had occurred on both of her big toes in the periungual area 20 years earlier. The lesions caused the nail plates to detach progressively and fall off eventually. Simultaneously, she noticed a large area of alopecia on her scalp. Three years before presenting to the clinic, after removing a plaster cast that had been applied to treat a fracture of the internal right malleolus, an ulcer developed on her right sole. Over the ensuing 3 years, the size of the lesion increased continuously and bullae developed occasionally, accompanied by sensations of burning and itching.On examination of her scalp, there was a large area of scarring alopecia on the vertex, with neither erythema nor follicular hyperkeratosis (Fig 1). The nails of both of her big toes were absent, and atrophy of the nail bed and matrix was noted References 1. Cram DL, Kierlana RR, Winkelmann RK. Ulcerative lichen planus of the feet: bullous variant with hair and nail lesions . Arch Dermatol. 1966;93:692-701.Crossref 2. Degos MMR, Delort J, Belaich S, Schnitzler L. Lichen plan érosif du pied: nouveau cas . Bull Soc Fr Dermaol Syphilol. 1966;73:844-846. 3. Gardner RK, Johnson HH, Binkley GW. Bullous lichen planus with onychatrophy . Arch Dermatol. 1955;71:636-637.Crossref 4. Altman J, Perry HO. The variations and course of lichen planus . Arch Dermatol. 1961;84:47-59.Crossref 5. Sarkany I. Atrophic lichen planus . Br J Dermatol. 1963;75:442-444. 6. Crotty CP, Daniel Su WP, Winkelmann RK. Ulcerative lichen planus: follow-up of surgical excision and grafting . Arch Dermatol. 1980;116:1252-1256.Crossref 7. Degos MMR, Desablet M, Chérif-Cheikh JL, Schnitzler L. Lichen érosìf des orteiles avec lichen érosìf buccal et vulvaire . Bull Soc Fr Dermatol Syphilol. 1967;74:718. 8. Zijdenbos LM, Starink TM, Spronk CA. Ulcerative lichen planus with associated sicca syndrome and good therapeutic result of skin grafting . J Am Acad Dermatol. 1985;13:667-668.Crossref 9. Rebora A. Lichen planus and the liver . Lancet . 1981;2:805-806.Crossref 10. Falk DK, Latour DL, King EL. Dapsone in the treatment of erosive lichen planus . J Am Acad Dermatol. 1985;12:567-570.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Mar 1, 1991

References