Violaceous Papules on the Palms and Soles

Background: Lichen planus (LP) is a condition with many clinical variants that can be quite varied in their presentation. Objective: We report a case of a 60-year-old woman who presented with a very unusual palmoplantar eruption characterized by violaceous pustule-like papules that was subsequently diagnosed as LP. Methods: The above case is reported, along with biopsy results. The patient was subsequently treated with a combination of topical corticosteroids and oral acitretin, and her clinical course was followed. Results: The eruption responded dramatically to our combination treatment and resolved by the 2-month follow-up. Conclusion: Palmoplantar LP is a rare variant of LP that bears little resemblance to its classic LP. This condition responds well to a combination of potent topical corticosteroids and oral acitretin.