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BACKGROUND Lichen planus may rarely be localized to the nails. OBJECTIVE A case of ungual lichen planus is reported that was misdiagnosed as onychomycosis. METHODS A 52-year-old woman had progressive nail dystrophy for 13 months that was unresponsive to oral terbinafine. A nail biopsy was performed. RESULTS Histopathologic findings were consistent with lichen planus. CONCLUSIONS Onychomycosis may be confused clinically with other causes of nail dystrophy. It is important to confirm the diagnosis of onychomycosis with appropriate laboratory or histologic analysis.
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