Revised: April 16, 2014
Accepted: May 16, 2014
Published online: August 2, 2014
Processing time: 189 Days and 14.3 Hours
Lichen planus is a common inflammatory disease but its perforating variety is not so common and it has been described in small number of text and articles. Here we reported a case of plantar lichen planus where there was a history of discharge of dark grains from the sole of foot and diagnosing the disease as eumycetoma of dark grains repeated antifungal therapy could not resolve the lesions and histopathologically it showed the classical pictures of lichen planus. Collaborating the clinical and histological features we have diagnosed the case as perforating lichen planus but Verhoeff-Van Gieson stain could not elucidate the perforating channel which ot difficult to delineate and often missed. So, we have put the diagnosis of plantar lichen planus and treated with intramuscular triamcinolone and the lesions resolved.
Core tip: The case was initially thought to be eumycetoma of dark grains as there was history of discharge of grains but after repeated antifungal therapy it did not resolve and in histopathology it was found as lichen planus. In this case the clinical features collaborating with perforating lichen planus but histopathology has failed to elucidate the perforating channel which is often missed and difficult to delineate. So, it is better to do a histopathology before giving the treatment as there is overlapping clinical features of various diseases.