A 40 year old man, Fitzpatrick skin type (FST) phototype 4, was examined for a lichen plan. The examination of his nails showed a gradual thinning of the proximal nail fold with the associated extension of the cuticle over the nail plate. Complete involvement of the matrix and nail bed in the pathological process leads to total loss of the nail plate with permanent atrophy and sometimes scarring in the nail area. Dorsal pterygium is characteristic of lichen planus and less often of peripheral vascular ischemia. It also occurs in severe dermatoses and radiotherapy.
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