Although reports in the literature are sparse, a definite relationship exists between nail anomalies and lichen planus. Ungual lichen planus may occur without any mucocutaneous signs, as has been documented by histologic studies. It may be the initial and most important clinical manifestation of the disease process, and permanent anonychia may result unless corticosteroid therapy is initiated promptly. Increased awareness of nail involvement will result in a more frequent diagnosis and better understanding of the disorder.