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Lichen planus (LP) and lichen nitidus (LN) present with varied morphology on the palms and soles. We present four unusual cases of palmoplantar LP and LN manifesting as hyperkeratotic plaques with pits. The diagnosis was confirmed histologically. Subtle features like presence of violaceous border suggests LP and plugs within the pits suggest LN.

The periungual area of all toenails, right thumbnail and left thumb, and index finger nails had similar indurated bulbous plaques extending into the nail plate and causing total loss of nail plate and bed [Figure 3]. Many causative factors have been reported such as diabetes mellitus, epilepsy, alcoholic cirrhosis, smoking, genetic, familial, but no such cause was ascertainable in our case. [4] Among the nonsurgical treatments, radiation therapy, vitamin E, local injection of calcium channel blockers, interferon, corticosteroids [5] or collagenase, and colchicine [6] have been successful only in isolated case reports.

Segmental vitiligo is a small but unique subset of vitiligo requiring due importance due to its lack of response to medical treatment but excellent response to surgical treatment. Characterization of the pattern of segmental vitiligo will also help to understand the pathogenesis of the disease. To characterize clinically the features of segmental vitiligo, a cross-sectional clinical study at dermatology outpatient department at AIIMS was carried out. Consecutive 188 patients were evaluated to characterize the clinical features of segmental vitiligo by detailed history, clinical examination, and photography. Frequency of each clinical feature was calculated. Certain features such as early onset, initial progression of disease followed by stability, blaschkoid pattern, irregular margins, leucotrichia within and beyond the vitiligo lesion, and islands of pigmented macules within the vitiligo lesion were found to be characteristic of the disease. A combination of various features such as early onset of disease, blaschkoid pattern, irregular margins, leucotrichia, and islands of pigmented macules within the vitiligo lesion are helpful in diagnosis of the disease.