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A Novel Visual Clue for the Diagnosis of Hypertrophic Lichen Planus
John Patrick Welsh, MD;
Christopher B. Skvarka, MD;
Herbert B. Allen, MD
Department of Dermatology, Drexel University College of Medicine, Philadelphia, Pa
Arch Dermatol. 2006;142:954.
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Dermatology has an illustrious history of formulating visual clues to facilitate diagnosis of oft-confused conditions. From the opulent ("crown-of-jewels") to the mundane ("apple jelly"), dermatologists have consistently drawn inspiration from the physical world when classifying disease. We intend to add to this literature by submitting a novel visual clue to aid in the diagnosis of hypertrophic lichen planus.
Given a causal linkage with the hepatitis C virus and recent case reports of malignant transformation, hypertrophic lichen planus requires astute and careful consideration.1-2 The condition is marked by firm, elevated, hyperkeratotic, red-brown to purple-gray plaques with chalky-white scale and follicular accentuation that imparts a geologic appearance to affected skin (Figure 1). Lesions thus bear a striking resemblance to the extrusive (or rapidly cooled) variants of igneous rock (Figure 2), characterized by a fine-grained (or aphanitic) . . . [Full Text of this Article]
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