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Bullous Variant With Hair and Nail Lesions

CAPT DAVID L. CRAM, USAF, (MC); ROBERT R. KIERLAND, MD; R. K. WINKELMANN, MD

Arch Dermatol. 1966;93(6):692-701.

Abstract
Three cases of an unusual syndrome of lichen planus, characterized by bullae and ulcerations confined to the feet and toes, permanent loss of toenails, and a cicatricial alopecia of the scalp, are presented. Two similar cases and seven nearly identical cases from the literature are reviewed. How this syndrome might relate to other forms of bullous lichen planus, to the Graham-Little syndrome, and to some of the other unique changes associated with lichen planus is discussed. The distinctive feature is the chronic, painful, and often disabling ulceration of the feet. Such ulceration is a major problem of diagnosis unless the relationship of ulcers to lichen planus elsewhere on the body is apparent. Skin grafting to the affected surfaces has been a successful form of therapy.

Author Affiliations
ROCHESTER, MINN

From the Mayo Clinic and Mayo Foundation, Section of Dermatology, Rochester, Minn. Dr. Cram is on assignment to the Mayo Graduate School of Medicine (University of Minnesota), Rochester, Minn.

Footnotes
Accepted for publication March 1, 1966.

The views expressed herein are those of the authors and do not necessarily reflect the views of the Air University, the United States Air Force, or the Department of Defense.

Reprint requests to 200 First St, SW, Rochester, Minn 55901.

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