A young female presented with lucy linear lesions on tongue since a month with elongation of nail fold beyond the nail bed. What is the diagnosis –
## **Core Concept**
The question presents a clinical scenario involving a young female with specific symptoms: linear lesions on the tongue and elongation of the nail fold beyond the nail bed. These symptoms suggest a systemic condition affecting multiple systems, including the skin and nails. The likely diagnosis relates to a condition known as **lichen planus**, which can affect the skin, mucous membranes, and nails.
## **Why the Correct Answer is Right**
The correct answer, **lichen planus**, is supported by the symptoms described:
- **Oral lesions:** The description of "lucy linear lesions on tongue" is indicative of **oral lichen planus**, which often presents with white, lacy patches or lesions.
- **Nail involvement:** The elongation of the nail fold beyond the nail bed, known as **onychoschizia** or more specifically **pterygium formation** in the context of lichen planus, is a characteristic feature of **nail lichen planus**. This condition can lead to scarring and deformities of the nails.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is incorrect because, without specifying what it is, we cannot directly assess its relevance, but given the symptoms, it's clear lichen planus fits better.
- **Option B:** Similarly, without specifics, we can't directly refute, but based on the provided symptoms, lichen planus seems more fitting.
- **Option C:** This might represent another condition; however, the combination of oral and nail symptoms points more towards lichen planus.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that **lichen planus** can affect multiple sites, including the skin, oral mucosa, and nails. The oral lesions often appear as **Wickham's striae**, which are white, lacy patches. The condition is associated with **T-cell-mediated autoimmune response**. A classic exam trap is to confuse it with other conditions like **lichenoid reactions** or **pemfigoid**, but the combination of oral and specific nail findings helps in differentiating.
## **Correct Answer: D. Lichen Planus**