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Byline: Hyun-Min. Seo, Se. Oh, Seon. Song, Ji. Park, Se. Park, Sung. Han, Joung. Kim Case History A 50-year-old man presented with multiple macules on his left palm. He was [...]

Byline: Raj. Chovatiya, Christina. Clarke Learning Points *Pityriasis rosea (PR) is a common papulosquamous eruption that classically consists of an initial salmon pink patch followed by a scaly pink papular [...]

Primary anetoderma is a rare idiopathic disease of the skin, characterized by circumscribed areas of loose skin, and loss of elastic fibers upon histopathologic examination. Two forms are traditionally distinguished, primary and secondary. Primary anetoderma occurs when there is no underlying associated skin disease, whereas the latter refers to an abnormal repair mechanism of preexisting skin lesions. We are reporting a case of primary anetoderma with lesions present all over the body, including the scalp, palms and soles, the sites that are not known to be involved in this condition.

Byline: Bhavana. Doshi, Vasudha. Belgaumkar, Nagbhushan. Chougule Sir, Neurofibromatosis (NF) is a set of inherited disorders originally designated as neurofibromatosis type 1 (NF1) and neurofibromatosis type 2 (NF2), and schwannomatosis [...]

Primary anetoderma is a rare idiopathic disease of the skin, characterized by circumscribed areas of loose skin, and loss of elastic fibers upon histopathologic examination. Two forms are traditionally distinguished, primary and secondary. Primary anetoderma occurs when there is no underlying associated skin disease, whereas the latter refers to an abnormal repair mechanism of preexisting skin lesions. We are reporting a case of primary anetoderma with lesions present all over the body, including the scalp, palms and soles, the sites that are not known to be involved in this condition. [ABSTRACT FROM AUTHOR]

Introduction: Palmoplantar lesions of lichen planus (LP) are uncommon and may not always have classical clinical features of LP. A variety of morphological types has been described in literature. Aim and Objectives: The aim was to study and classify the clinical variants into distinct easily recognisable categories for quick recognition and early treatment initiation. Methods: All patients diagnosed with LP over a period of 5 years were evaluated for palmoplantar lesions in our hospital. The clinical and histopathological features of the palmoplantar lesions were then studied. Results: Out of 424 patients of LP, 55 (12.9%) had palmoplantar lesions. Histopathology was consistent or at least compatible with LP in 44/55 patients. For the purpose of assessment, only patients with histopathology consistent with LP were included (n = 44) in the study. Just over half of the patients were male, with most patients (43.2%) having had LP lesions elsewhere for 6 months before palmoplantar lesions were noticed. Soles were more frequently involved than palms. The sites most often involved were the centre of the palms (45.2%), and the instep of the soles (63.9%). The predominant morphological presentation was psoriasiform (47.7%). One patient had ulcerative lesions of LP on both his soles which is a very rare variant. Notably, nearly half of the patients (20/44) had mucosal (mostly oral) lesions characteristic of LP. This was significant as typical oral lesions of LP help in identifying palmoplantar lesions that do not have classical lichenoid morphology. Conclusion: LP lesions on palms and soles need to be identified keeping a high index of suspicion and differentiated from other papulosquamous conditions so that specific treatment can be initiated early. [ABSTRACT FROM AUTHOR]

Background: Palmoplantar keratoderma (PPK) is a heterogeneous group of hereditary or acquired disorders characterised by excessive epidermal thickening of the palms and soles. Proper knowledge about the aetiology of the disease and clinico-demographic profile helps in planning management and predicting outcomes. Aims and Objective: To determine the prevalence of different dermatoses and describe their clinico-histological correlation in acquired palmoplantar keratoderma. Materials and Methods: An institution-based cross-sectional study conducted after obtaining Ethics-Committee permission and consent from participants. Patients of any age or gender presenting with acquired PPK were recruited. The calculated sample size was 67 by using the prevalence rate (p) of 22.2%, allowable error (L) of 10%, the confidence level of 95% (z = 1.96), and an infinite population size of 20,000. Patients were evaluated by taking demographic and clinical data in a pre-designed case record form, necessary laboratory investigations and histopathological examination that wereevaluated by three blinded experts. The pooled data were analysed with statistical software. Results: Among the 67 participants, Psoriasis was diagnosed clinically in 39 (58.2%) and histologically in 7 (10.4%), Lichen planus (LP) clinically in 16 (23.9%) and histologically in 9 (13.4%), Pityriasis rubra pilaris (PRP) in 8 (11.9%) patients clinically and 7 (10.4%) histologically and Hyperkeratotic eczema (HKE) in 4 (6%) clinically and 43 (64.2%) histopathologically. There was very poor inter-rater agreement (Kappa = 0.148, SE 0.0047, 95% CI 0.057 to 0.24). The clinico-pathological correlation was found to be agreeable in 17.9% Psoriasis, 56.2% LP and 87.5% PRP. HKE was commonly misdiagnosed as Psoriasis in 65.1% of patients. Conclusion: Hyperkeratotic lesions of the palm and sole often present with overlapping clinical features and a skin biopsy has to be done to aid in diagnosis. Limitation: Stratification of the clinical expertise of clinicians was done during the analysis. [ABSTRACT FROM AUTHOR]

Background: Palmoplantar lesions in lichen planus (LP) are uncommon. In such cases, diagnosis is usually missed. This study was conducted to document various clinical and histopathological features of palmoplantar LP. Materials And Methods: A total of 18 patients from our outpatient department with lesions of LP, either predominantly or exclusively on palms and/or soles were studied. Patients with history of drug intake in recent past and patients with classical acute widespread LP with a few lesions on palms or soles were excluded. In each patient, diagnosis was made on clinicopathological correlation. Various clinical and histopathological features were analyzed. Results: Average age of onset was 38 years. Male: female ratio was 1:0.6 and average disease duration was 11 months. Exclusive palm or sole involvement was seen in 4/18 patients. Itching was the most common symptom. Clinically the most common variant was hypertrophic. Histologically presence of parakeratosis, spongiosis, lack of melanophages, and lack of hypergranulosis in some cases was seen in addition to classical features of LP. In 3 out of 4 patients with exclusive palmoplantar involvement diagnosis of LP was missed clinically. Conclusion: Involvement of palms and soles in LP poses a diagnostic challenge due to variable presentations. Histopathology is of vital importance for correct diagnosis and treatment. [ABSTRACT FROM AUTHOR]

The article explores the occurrence of Aquagenic Syringeal Acrokeratoderma (ASA) as an atypical manifestation in a patient recovering from dengue fever. Topics include the rarity of ASA, its association with eccrine gland dysfunction, the potential role of dengue fever and Nonsteroidal Anti-Inflammatory Drugs ( NSAIDs) in triggering ASA, and the successful management using topical therapy.

The article focuses on a case report describing cutaneous chronic graft-versus-host disease (cGVHD) presenting as acral verrucous lesions resembling verruca vulgaris in a post-allogenic bone marrow transplant patient. Topics include the atypical presentation of cGVHD, diagnostic challenges initially misidentified as warts, histopathological findings confirming the cGVHD diagnosis, and the successful resolution of lesions with ruxolitinib therapy.

The article presents a case study of paraneoplastic syndrome involving malignant acanthosis nigricans (MAN), tripe palms, and an unusual presentation of acute eruptive verrucous seborrheic keratosis (SK) on the scalp. The patient presented with skin pigmentation, hyperpigmentation on the hands, verrucous plaques in the oral cavity, and skin-colored plaques on the scalp.

Palmo-plantar keratodermas (PPKD) are a diverse group of acquired and hereditary disorders, characterized by excessive thickening of the skin of palms and soles. Here, we report a case of Type I or Buschke-Fischer-Brauer variant of punctate palmo-plantar keratoderma, in a 66-year-old gentleman. The association of our case with Hodgkin's lymphoma along with linear configuration of lesions on the palms evoked the current report. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 53‑year‑old White female presented with a 4‑month history of painful scaly plaques on the palms and feet; progressed into inflammation with fissuring, affecting the fingers and toes; the patient was a current smoker with a 40‑pack‑year history; on clinical examination, there was symmetrical psoriasiform hyperkeratosis on both palms and soles; and there was also subungual hyperkeratosis and dystrophic nails.

Mal de meleda (MdM), a rare autosomal recessive genodermatosis is characterized by erythema and hyperkeratosis of the palms and soles with a sharp demarcation and that progress with age (progrediens) and extend to the dorsal aspects of the hands and feet (transgrediens). It has been associated with various conditions albeit rarely with congenial cataract. Ocular lens and the skin have the same embryological origins. We hereby present this novel case report of Mal de meleda in association with congenital posterior subcapsular cataract which to the best of our knowledge has not been reported from India before. [ABSTRACT FROM AUTHOR]

The article focuses on two sporadic cases of Haber's syndrome in India, characterized by rosacea-like features and widespread verrucous keratotic lesions. Topics include the clinical presentation of Haber's syndrome, its distinguishing features such as stellate seborrheic keratoses (SK), and its differentiation from other similar conditions like Dowling-Degos disease and Acropigmentation of Kitamura.

A case study of 41‑year‑old woman is presented with itching, wrinkling and thickening of bilateral hands following exposure to water for several months. Topics include examines no history of hyperhidrosis, atopy any systemic illness, drugs or any relevant family history was elicited as examination revealed bilaterally symmetrical, accentuated wrinkling of dorsa of hands and palms with distorted dermatoglyphics.

Hand and foot syndrome (HFS) is a well‑known complication of chemotherapeutic drugs given in a dose‑dense manner. Our patient was a 52‑year‑old female with metastatic breast carcinoma on salvage chemotherapy regimen with docetaxel at a dose of 60 mg/m2. The patient had grade 3 HFS characterized by symmetrical, tender, and erythematous skin lesions over the palms and soles associated with dysesthesia necessitating interruption of treatment. She developed this syndrome at a much lower dose than previously described due to her altered hepatic function. An insight regarding this unique distressing side‑effect and assessment of various contributing factors would help us identify and treat the patient at the earliest. [ABSTRACT FROM AUTHOR]

Aquagenic keratoderma (AK) is a rare acquired skin condition characterized by recurrent and transient white papules and plaques associated with a burning sensation, pain, pruritus and/or hyperhidrosis on the palms and more rarely, soles triggered by sweat or contact with water. Often AK cause significant discomfort, thus requiring an appropriate therapy. Topical aluminum‑based products are the most commonly used medications, but they are not always effective. We report a case of AK unresponsive to topical 20% of aluminum chloride successfully treated with tap water iontophoresis. [ABSTRACT FROM AUTHOR]

Rowell's syndrome (RS) is recognized since 1963 as a presentation of lupus erythematosus (LE) with erythema multiforme-like lesions and characteristic immunological changes. Antiphospholipid syndrome (APS) encompasses antibodies to phospholipids/phospholipid-binding cofactor proteins and/or circulating lupus anticoagulant with clinical manifestations of thrombosis such as recurrent spontaneous abortions, etc. A 32-year-old female with primary infertility since marriage (7 years) and sequential appearance, for the past 6 months, of various lupus-specific cutaneous lesions, "targetoid" lesions on palms, musculoskeletal, ocular and auditory (sensorineural hearing loss [SNHL]) complaints with positive serological profile for SMD-1, SS-A/Ro, SS-B/La, U1-snRNP, Ku, antiphospholipid and anticardiolipin antibodies, and histopathologically confirmed LE is presented as a case of concurrent overlap syndrome, RS and APS, primary infertility, and SNHL. A brief review of RS including analysis of data of cases reported from India hereto vis-a-vis that of cases worldwide up to 2012 has also been done. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 13‑year‑old boy presented with pruritic scaly follicular papules, which coalesced to form plaques in axillae, flexural aspect of elbows and knees, groins, and ankles along with hyperkeratosis of palms and soles since last 4 years; on examination, the patient was of normal physical and mental development; and there was no evidence of any associated systemic disease.

Lichen planus (LP) is a chronic inflammatory skin disease characterized by polygonal, violaceous papules commonly involving flexural areas of the wrists, legs, and oral and genital mucous membranes. This report describes a patient who presented with asymptomatic black colored patches on both palms simulating Tinea nigra, a superficial fungal infection. She was previously diagnosed as allergic contact dermatitis and was being treated with potent topical steroid i.e. clobetasol propionate 0.05% and white soft paraffin. Dermatoscopy of the lesion showed brownish pigmentation along ridges of the dermatoglyphics. A biopsy from the lesional skin showed findings of lichen planus. Our case highlights the potential diagnostic confusion that can occur with unusual variants of palmoplantar lichen planus and importance of histopathology in diagnosis of such unusual lesions. [ABSTRACT FROM AUTHOR]

The article discusses cases of Sybert's keratoderma. The case involved a family of five siblings in which 3 of the siblings have a history of thickening and scaling over the palms and soles since their birth. Results of the examination showed the presence of hyperkeratosis of the palms and soles which reached the dorsum of the hands and feet. An overview of the distinct patterns of palmoplantar keratodermas is provided.

Olmsted syndrome is a rare disorder characterized by the combination of periorificial, keratotic plaques and bilateral palmoplantar keratoderma. New associated features are being reported. Olmsted syndrome is particularly rare in a female patient, and we report such a case in a six year-old Indian girl, who presented with keratoderma of her soles since birth and on her palms since the age of two years along with perioral and perinasal hyperkeratosis. She had sparse, light brown, thin hair. Although the psychomotor development of the child was normal until 18 months of age, the keratoderma plaques had restricted the child's mobility after that stage. [ABSTRACT FROM AUTHOR]

Leprosy affects mainly those areas of skin which have a relatively lower temperature and are more exposed to trauma. Certain zones like scalp, palms and soles, genitalia, groins, axillae, eyelids, transverse band of skin over lumboscaral area, midline of back and perineum have been described to be immune to the development of lesions in leprosy. But clinical, histological and bacteriological evidence of involvement of these so called immune zones though infrequent have been documented. Hence, these immune zones should be termed as relatively immune, rather than absolutely immune zones of leprosy. [ABSTRACT FROM AUTHOR]

Granulocyte-macrophage colony-stimulating factor (GM-CSF) infusion has been reported with the development of transient maculopapular rash with spontaneous resolution. A 54-year-old Indian female developed intense erythematous generalised rash involving the face, trunk, extremities, palms and soles following GM-CSF infusion. Focal exudation and purpura were seen. Infusion was stopped and she was managed with a short course of systemic steroids. As yet, the development of such an atypical, severe rash following this cytokine infusion has not been reported in the literature. [ABSTRACT FROM AUTHOR]

A case study presents a 55-year-old woman with generalized hyperpigmentation diagnosed as Acanthosis Nigricans (AN) coexisting with Lichen Planus Pigmentosus (LPP), a unique association. Despite the common link of generalised AN with malignancy, this case showed no evidence of internal malignancy, highlighting the rarity of such benign presentations.

Hyperacute GVHD (HaGVHD) is a rare complication of hematopoietic stem cell transplantation (HSCT) occurring before engraftment, a syndrome commonly involving skin and/or gut and/or liver, with increased morbidity and mortality. Myeloablative conditioning (MAC) regimes and mismatched donor transplants have an increased risk for HaGVHD. There is a higher chance of steroid-refractoriness and chronic GVHD in those who develop HaGVHD. There is limited literature about HaGVHD, especially in the paediatric age group. This retrospective single-centre case series included five paediatric patients who underwent HSCT between 1st April 2013 and 31st July 2015 at a tertiary care centre in South India, who fulfilled the criteria for HaGVHD as per criteria by Kim et al. and whose follow up data was available. We noted their risk factors, clinical course and prognosis. There were five paediatric HaGVHD patients. The risk factors noted among them were MAC regimen in three and mismatched unrelated donor sources in three. Two had steroid-refractory disease, four went on to develop chronic GVHD and three died of GVHD or treatment-related complications. A high index of suspicion is necessary to recognize HaGVHD, especially in patients with known risk factors developing a fever with rash post-HSCT. [ABSTRACT FROM AUTHOR]

Gorlin‑Goltz syndrome or nevoid basal cell carcinoma syndrome is characterized by multiple basocellular epitheliomas, keratocysts in the jaws, bifid ribs, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. We describe a case of Gorlin‑Goltz syndrome illustrating the importance of a thorough examination including the examination of palms and soles and detailed investigations in a patient having lesions suggestive of basal cell carcinoma and multiple naevi. [ABSTRACT FROM AUTHOR]

The article describes the case of a 60-year-old man who presented with painful skin lesions on the palms and soles. Multiple hyperkeratotic papules and plaques at both sites were seen by physical examination. A punch biopsy was conducted and revealed epidermal hyperkeratosis and acanthosis with central invagination and focal parakeratosis. The patient was diagnosed with palmoplantar keratoderma based on the clinical and histopathological findings.

The article presents a case study of a patient presented with reticulate pigmentation over face, neck, v of chest, forearms, dorsae of hands and feet and palms and soles, along with dystrophic nails, non‑cicatricial alopecia of scalp with bleaching of pigmentation. It discusses that Dermatopathia pigmentosa reticularis is characterised by a triad of widespread reticular pigmentation, non‑scarring alopecia and nail changes.

A case study is presented of a 45‑year‑old female presented with bluish green hyperkeratotic plaques in both palms and soles. It informs that the patient was diagnosed as a case of alkaptonuria, an autosomal recessive disorder, and she was given a high dose of Vitamin C. It informs that the patient also showed degenerative changes in both Achilles tendons and tear in left side.

Lichen planus (LP) is a common idiopathic inflammatory disorder that affects the flexor aspect of the wrists, the legs, and the oral and genital mucosa. Depending upon the site of involvement, LP can be divided into mucosal, nail, scalp, or palmoplantar types. Palmoplantar LP can pose a diagnostic problem to the clinician as it resembles common dermatoses like psoriasis, verruca, corn, calluses, lichenoid drug eruption, and papular syphilide of secondary syphilis. In this case report, we describe a 4-year-old male child who presented with highly pruritic erythematous to violaceous hyperkeratotic papules and plaques on his palms and soles. Typical LP papules were noted on the upper back. Histopathology of the papular lesion showed features of LP. Dermatoscopy of a papule from the back showed the characteristic Wickham striae. We report this rare involvement of palm and soles in a case of childhood LP. [ABSTRACT FROM AUTHOR]

A letter to the editor about the case of a 60-year-old female patient diagnosed with alkaptonuria associated with degenerative collagenous plaques on palms is presented.

Carotenemia is characterized by an abnormal yellowish orange pigmentation of the skin, predominantly seen on the palms and soles. Although it may be associated with several diseases such as diabetes, hypothyroidism and anorexia nervosa, it is caused by excessive intake of carotene-rich food such as oranges and carrots in most cases. The condition is harmless, but it can lead to a mistaken diagnosis of jaundice. Herein, an interesting case of carotenemia is described in a 32-year-old female secondary to increased ingestion of oral sweet potatoes and oranges. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 35‑year‑old man, with sudden onset of skin stiffness arising from the abdomen, which also involved the arms, elbows, palms, and neck. It mentions that the patient underwent treatment with 60 mg of prednisolone and 15 mg of methotrexate weekly; and after 2 weeks, the symptoms were relieved, and the patient was discharged with oral medication.

Background: Scalp psoriasis and psoriasis limited to palms and/or soles have been referred to as difficult to control psoriasis. Contact allergy has long been suspected to aggravate existing lesions and cause resistance to therapy in these psoriasis variants. Objectives: The objective of the study was to assess common contact allergens in patients with palmoplantar and scalp psoriasis and the impact of their avoidance on dermatology life quality index (DLQI). Materials and Methods: A total of 54 patients with palmoplantar and scalp psoriasis were patch tested with Indian Standard Series. The patch test results were read on day 2 and day 4. DLQI was calculated before patch testing and at 1 month and 3 month in patch test positive patients after instructing allergen avoidance. Results: Sixteen out of fifty-four patients (29.62%) showed positive patch test reactions. Metal antigens like nickel and cobalt were the most common sensitizers identified. Statistically significant improvement in DLQI was observed at 1 month and at 3 month of allergen avoidance. Conclusion: Patch testing is a useful test to determine the triggering or aggravating antigens in patients with palmoplantar and scalp psoriasis and subsequent allergen avoidance should be stressed on. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 15-year-old girl who presented a 1-year history of asymptomatic, symmetrical, and white lesions located on her palms. The patient underwent clinical and hispathological examination and was diagnosed with aquagenic syringeal acrokeratoderma (ASA) which is a rare disorder that is characterized by symmetrical, edematous, white and translucent papules and plaques.

Pustular psoriasis is a specialized variant of psoriasis which can be life threatening if not treated at the earliest. The pathogenesis has been recently linked to the role of interleukin 36. Apart from the corticosteroids, systemic antipsoriatics like acitretin, cyclosporine and methotrexate have been used with some success though unpredictable. With recent identification of role of IL-36 in the pathogenesis of pustular psoriasis, biologics targeting the IL-36 receptors have been used to manage the situation with high degree of success. This narrative review deals with the recent concepts of pathogenesis of pustular psoriasis as well as the current management scenario. [ABSTRACT FROM AUTHOR]

Rash and fever are some of the most common chief complaints present in paediatric dermatology emergencies. The spectrum of differential diagnosis is broad, including many different infectious and some non-infectious agents. A systematic approach involving detailed history taking, careful clinical examination along with particular attention to epidemiological features are the most important factors to make a diagnosis. This article reviews the morphological patterns of various causes of fever with rash in children, including infectious as well as non-infectious causes, with special emphasis on the Indian scenario. We intend to highlight the clinical characteristics of each cause, which will not only help make a clinical diagnosis but also distinguish benign versus life-threatening causes of skin rash in febrile paediatric patients and provide early medical intervention. [ABSTRACT FROM AUTHOR]

A case study of a 7 hours old girl displaying ichthyosiform erythroderma on the trunk and limbs except for palms and soles. Topics include general erythroderma had abated, leaving ichthyosis in the linear patterns of Blaschko lines; and pattern of Blaschko lines upon a background of severe erythroderma, along with follicular atrophoderma and cicatricial alopecia on the scalp with other ocular symptoms.

Aquagenic syringeal acrokeratoderma is a rare, transient, and usually bilaterally symmetric, palmoplantar keratoderma. Patients complain of tingling and pain in the hands starting a few minutes after exposure to water and lasting for 20‑30 minutes after removal. Clinically, there is marked wrinkling with edematous white papules on the palms or, less often, the soles. We present the case of a 21‑year‑old woman who used spironolactone for polycystic ovary syndrome and had similar clinical features 2 weeks later, after withdrawing the drug. [ABSTRACT FROM AUTHOR]

Mal de Meleda is a rare autosomal recessive transgradient palmoplantar keratoderma characterized by transgradient keratoderma with associated scleroatrophy, nail changes, pseudoainhum around digits and perioral erythema, without a tendency for spontaneous resolution. Involvement of the lip by keratoderma has not been reported in the English literature. Here we present two cases of Mal de Meleda with unusual lip involvement. The first case was a 15-year-old girl, born of second-degree consanguineous marriage, who presented with transgradient palmoplantar keratoderma from 6 months of age, with lichenoid papules and plaques on the elbows and knees, conical tapering of the distal digits, flexion deformity of several fingers, digital constriction, knuckle pads and lip involvement. The second case was a 24-year-old male with transgradient palmoplantar keratoderma since birth. He also had scaly plaques on the extensors of bilateral knees and elbows, knuckle pads, pseudosclerodermatous fingers with conical tapering, digital constrictions at various places with mild flexion deformity and lip involvement. Both patients were otherwise normal without any family history. [ABSTRACT FROM AUTHOR]

Our skin is the largest organ and is composed of the dermis and epidermis. The skin surface has lines in the direction of elastic tension. The palmar and plantar skin lines are established before birth in the intrauterine development of the embryo. Dermatoglyphics is the study of epidermal lines on the palmar and plantar surface. It is a branch of biology, anthropology, genetics, and dermatology. Dermatoglyphics are closely associated with genetic factors. These attributes once formed in the womb remain unique and persist throughout the life of an individual unless the dermis is damaged. Digital and palmar dermatoglyphics are represented by fingerprint patterns, atd angle, a, b, c, d triradii, mail line index, etc. Sometimes either due to hereditary reasons, the pressure of intrauterine factors, or external environmental factors, chromosomal aberrations occur in the fetus. These aberrations are reflected in the form of increased angle of atd, variation in pattern frequency or ridge count between a-b triradii (ABRC), presence of unnatural flexion creases, and others in the fingerprints, palmprints, or footprints. These aberrations in dermatoglyphics are useful in studying the genetic abnormalities in ailments, personality disorders, and criminal tendencies. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 51-year-old woman with plantar erosive lichen planus who achieved significant improvement with tofacitinib treatment after failing multiple other therapies. Topics discussed include the pathogenesis of lichen planus, the mechanism of action of tofacitinib, and the potential of tofacitinib as a therapeutic option for severe cases of plantar erosive lichen planus refractory to other treatments.