A 30 year old male came with pruritic papule over flexor aspect of right forearm which is purple in colour.There is also pterygium of nails. Diagnosis?
## **Core Concept**
The question describes a patient with a pruritic papule on the flexor aspect of the right forearm that is purple in color, along with pterygium of the nails. This presentation suggests a skin condition that affects both the skin and nails, likely an autoimmune or inflammatory disorder.
## **Why the Correct Answer is Right**
The description provided matches **lichen planus**, a chronic inflammatory condition that affects the skin and mucous membranes. Lichen planus can present with pruritic, polygonal, flat-topped papules, often on the flexor surfaces of the limbs, which can be purple in color due to inflammation. The presence of pterygium (a condition where there is scarring and subsequent fusion of the skin of the nail fold to the nail plate) in the nails is a characteristic feature of lichen planus.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is not provided, but typically, conditions like eczema or psoriasis could be considered. However, while they can cause pruritic papules and nail changes, the specific combination of findings (especially pterygium) and location (flexor aspect) makes them less likely.
- **Option B:** Similarly, without specifics, it's hard to address, but conditions like dermatitis might not fully explain the nail findings.
- **Option C:** If another skin condition were listed, it might not align with the combination of skin and nail findings described.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that lichen planus can affect multiple sites, including the skin, mouth, esophagus, and genitalia. The presence of **Koebner phenomenon** (lesions appearing at the site of trauma) and **nail involvement**, such as pterygium or thinning of the nails, supports the diagnosis of lichen planus.
## **Correct Answer:** . Lichen Planus