Nail lichen planus in children: clinical features, response to treatment, and long-term follow-up.

Abstract

OBJECTIVE:

To report clinical features, response to treatment, and long-term follow-up of nail lichen planus in children.

DESIGN:

Retrospective study involving 15 children with nail lichen planus.

SETTING:

Outpatient consultation for nail disorders at the Department of Dermatology of the University of Bologna, Bologna, Italy.

PATIENTS OR OTHER PARTICIPANTS:

We diagnosed nail lichen planus in 15 children younger than 12 years, including 10 children with typical nail matrix lesions, 2 children with 20-nail dystrophy (trachyonychia), and 3 children with idiopathic atrophy of the nails. Only 2 of the 15 children had oral lichen planus; none had cutaneous lesions. A nail biopsy confirmed the diagnosis in all cases.

INTERVENTION:

Intramuscular triamcinolone acetonide, 0.5 to 1 mg/kg per month, was prescribed to children with typical nail lichen planus and prolonged from 3 to 6 months until the proximal half of the nail was normal. No treatment was prescribed to patients with 20-nail dystrophy or idiopathic atrophy of the nails.

RESULTS:

Treatment with systemic corticosteroids was effective in curing typical nail lichen planus. Two children experienced a recurrence of the disease during the follow-up. Recurrences were always responsive to therapy. The 2 children with 20-nail dystrophy improved without any therapy. Nail lesions caused by idiopathic atrophy of the nails remained unchanged during the follow-up period.

CONCLUSIONS:

Nail lichen planus in children is not rare but probably underestimated. It often presents with atypical clinical features such as 20-nail dystrophy or idiopathic atrophy of the nails.

• Authors: A Tosti, B M Piraccini, S Cambiaghi, M Jorizzo
• Journal: Archives of dermatology (Arch Dermatol) Vol. 137 Issue 8 Pg. 1027-32 (Aug 2001) ISSN: 0003-987X [Print] United States
• PMID: 11493095 (Publication Type: Journal Article)

Topics

• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Infant
• Lichen Planus (drug therapy, pathology)
• Male
• Nail Diseases (drug therapy, pathology)
• Retrospective Studies
• Time Factors