Careers  |  Sign In  |  Register  |   Twitter

28-Year-Old Male Develops Brittle Nails & Rash on Leg

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

For several months, a 28-year-old man has had changes to his nails, which have also become more brittle. He denies any history of trauma to the nails. When asked if he has any rashes, he lifts his pant leg, as shown here.

What do you suspect?

Choose one to reveal diagnosis and discussion

Lichen planus
Psoriasis
Trauma
Iron deficiency
Beau lines

Answer: Lichen planus

See the full case at Consultant360

Biopsy of a lesion on the patient’s shin confirmed the diagnosis of lichen planus. This condition is associated with nail changes in up to 10% of affected patients. Among the changes seen with lichen planus are roughtextured nails with longitudinal ridging. Corticosteroids— either topical with occlusion or administered by injection—may help resolve these nail changes.

Psoriasis is usually characterized by nail pitting and separation of the nail plate from the nail bed. Beau lines are transverse lines in the nail plate that result from trauma to the cuticle; this patient had no history of trauma. Iron deficiency anemia typically produces spoon-shaped, or concave, nails.

More Cases
45-Year-Old Female with Asymptomatic Solitary Papule

Can you identify this skin ailment? Take this week's Derm Case Challenge to validate your diagnosis.

45-Year-Old Female with Asymptomatic Solitary Papule
38-Year-Old Male with Left Thumb Lesion

Derm Case Challenge

38-Year-Old Male with Left Thumb Lesion
75-Year-Old Female with Rash on Lower Extremities

Test your dermatology knowledge with this week's Derm Case Challenge.

75-Year-Old Female with Rash on Lower Extremities
40-Year-Old Male with Growing Lesion on Back

Can you identify this skin ailment? Take this week's Derm Case Challenge to validate your diagnosis.

40-Year-Old Male with Growing Lesion on Back
45-Year-Old Male with Photodistributed Rash

Derm Case Challenge

45-Year-Old Male with Photodistributed Rash
46-Year-Old Female with Knee and Lower Back Aches

Derm Case Challenge

46-Year-Old Female with Knee and Lower Back Aches
75-Year-Old Female with Rash on Lower Extremities

Test your dermatology knowledge with this week's Derm Case Challenge.

75-Year-Old Female with Rash on Lower Extremities
40-Year-Old Female with Inframammary Rash

Derm Case Challenge

40-Year-Old Female with Inframammary Rash
42-Year-Old Male with Abnormal-Looking Thumbnails

Test your dermatology knowledge with this week's Derm Case Challenge.

42-Year-Old Male with Abnormal-Looking Thumbnails
27-Year-Old Male with Bumps on Scalp and Neck

Derm Case Challenge

27-Year-Old Male with Bumps on Scalp and Neck