This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Lichen planus (nail)

Authoring team

Can be seen in 10% of patients with lichen planus. Changes are more prominent on the fingernails than in toenails (1).

Early signs include thinning of the nail plate and longitudinal ridging. Continued involvement leads to scarring of the nail matrix, dorsal pterygium formation, sandpaper nails (trachonychia), and possibly complete loss of the nail plate

Some patients may exhibit a variant of lichen planus called 20-nail dystrophy, where these findings are the only presenting sign of disease on all 20 nails. This subtype is much more common in children compared to adults. (2)

Reference:

  1. Gupta MK, Lipner SR. Review of Nail Lichen Planus: Epidemiology, Pathogenesis, Diagnosis, and Treatment. Dermatol Clin. 2021 Apr;39(2):221-230
  2. Jacobsen AA, Tosti A. Trachyonychia and Twenty-Nail Dystrophy: A Comprehensive Review and Discussion of Diagnostic Accuracy. Skin Appendage Disord. 2016 Sep;2(1-2):7-13.

Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2026 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.