A 50 year old patient with hepatitis C presents with the rash shown above. It also affects the wrists, elbows, nails, and oral mucosa. Note that the rash is somewhat shiny and flat. The lesions are itchy.
A biopsy is shown below:
Challenge: What's your diagnosis?
First and third images shown under Creative Commons Attribution Share-Alike License; second image shown under Fair Use.
Algae
ReplyDeleteLichen planus is shown here; the second image shows a thick, violaceous, hyperkeratotic plaque with a white lacelike pattern called Wickham’s striae. Histopathology shows an interface dermatitis with apoptotic keratinocytes at the dermal-epidermal junction and an underlying lymphocytic infiltrate.
Sources: UpToDate; Wikipedia.