Palmoplantar lichen planus is a rare variant of lichen planus that predominantly affects the palms and soles and often lacks classical clinical features. Due to its variable morphology and resemblance to other palmoplantar dermatoses, diagnosis is frequently delayed or missed. We report a case of a 23-year-old female presenting with violaceous papules over the palms and soles associated with oral mucosal involvement. Dermoscopic examination revealed fine white linear streaks, and histopathological analysis demonstrated features consistent with lichen planus. The patient showed significant clinical improvement following treatment with oral acitretin. This case highlights the importance of clinicopathological correlation in diagnosing atypical palmoplantar eruptions and emphasizes early recognition to avoid misdiagnosis and delayed treatment.