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What next for these wounds that won’t respond to steroids?

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20 June 2019
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erythematous
Figure 1. Erythematous-violaceous hyperkeratotic plaques on the right lateral calf. Figure 2. A classical finding of lichen planus-nail change is dorsal pterygium.

A 63-year-old male presents with an eight-year history of pruritic, crusty wounds on his calves, which then spread to his thighs.

A biopsy six months ago showed features of lichen simplex. He has tried steroid creams with no success.

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