Isolated Nail Lichen Planus in an Indian Boy

A 12-year-old Indian boy presented with isolated nail lichen planus, characterized by progressive, destructive lesions on all fingernails and toenails over 1 year, without any associated itching, pain, or discharge. Initial misdiagnosis as onychomycosis led to ineffective treatment. Histopathological examination confirmed nail lichen planus, and the patient was treated with six monthly intramuscular triamcinolone acetonide injections and topical tacrolimus, resulting in significant improvement in most nails after 1 year, though the great toenails showed less response. The case highlights the rarity of isolated nail lichen planus in children, the importance of accurate diagnosis, and the effectiveness of triamcinolone acetonide in treatment.