A young lady presents with white lacy lesions in oral cavity and her proximal nail fold has extended onto the nail bed. What is the likely diagnosis?
**Core Concept:** Lichen planus is a chronic, immune-mediated, mucocutaneous disease that presents with various clinical manifestations. In oral form, it presents as white lacy lesions, while in the nail form, it may cause nail dystrophy.
**Why the Correct Answer is Right:** The correct answer (C) refers to the clinical manifestation of lichen planus in the oral mucosa, which presents as white, lacy, and reticular lesions. These lesions are characteristic and often accompanied by nail dystrophy, as seen in this case. The correct answer encompasses both the oral and nail manifestations of the disease.
**Why Each Wrong Option is Incorrect:**
A. Lichen planus is a correct diagnosis, but option A focuses on the oral manifestation without considering the nail involvement.
B. Lichen planus is a correct diagnosis, but option B focuses on the nail involvement without considering the oral lesions.
D. Lichen planus is a correct diagnosis, but option D focuses on the nail involvement and oral lesions but does not include the specific clinical feature mentioned in the correct answer (white lacy lesions).
**Why Lichen Planus is Correct:** Lichen planus is an autoimmune disease affecting the skin, mucous membranes, and nails. The clinical features mentioned in the question align well with the oral and nail manifestations of lichen planus. The white lacy lesions in the oral cavity and the nail dystrophy are key diagnostic features.
**Clinical Pearl:** Lichen planus is a clinical diagnosis based on the characteristic white reticular lesions in the oral cavity and nail dystrophy. It is essential to consider this diagnosis when evaluating a patient with mucocutaneous lesions and nail abnormalities.