Case Report
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World J Dermatol. Aug 2, 2014; 3(3): 73-75
Published online Aug 2, 2014. doi: 10.5314/wjd.v3.i3.73
Plantar lichen planus masquerading eumycetoma of dark grains
Anirban Das, Dipti Das, Ramesh Chandra Gharami
Anirban Das, Dipti Das, Ramesh Chandra Gharami, Department of Dermatology, Medical College and Hospital, Kolkata 700073, India
Author contributions: Das A was the correspondent author and took the photographs; Das D also seen the case and discussed with other 2 contributors and did histopathology; Gharami RC previous two authors consulted the author for histopathology and the confusion between eumycetoma and plantar lichen planus and for further management and consultation for Verhoeff-Van Gieson.
Correspondence to: Dr. Anirban Das, MBBS, Department of Dermatology, Medical College and Hospital, 88, College Street, Kolkata 700073, India. dr.anirban23@gmail.com
Telephone: +91-97-35772751
Received: February 20, 2014
Revised: April 16, 2014
Accepted: May 16, 2014
Published online: August 2, 2014
Processing time: 189 Days and 14.3 Hours
Abstract

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.

Keywords: Plantar lichen planus; Masquerading eumycetoma; Perforating lichen planus

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.