Lichen planus (LP) is an inflammatory condition that may affect the skin, scalp, mucosa, and nails. Nail lichen planus (NLP) may cause permanent nail loss and have a negative impact on daily functioning [1–3]. Therefore, early recognition, diagnosis, and treatment are necessary. NLP is characterized by longitudinal nail plate ridging and fissuring [2]. As the disease progresses, a dorsal pterygium, or scar, may develop, resulting in permanent nail loss [4, 5]. Approximately 4–12% of individuals with NLP experience permanent damage to at least one nail [6]. Little is known about disease pathophysiology, although abnormal toll-like receptor activity is hypothesized to play a role [1].