Lichen nitidus
 | This articlemay be too technical for most readers to understand.(October 2012) |
| Lichen nitidus | |
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| Photography of lichen nitidus: A) Glistening forearm papules; B) Papular lesions of lower limbs | |
| Specialty | Dermatology |
Lichen nitidusis a chronic inflammatory disease of unknown cause[1]characterized by 1–2 mm, discrete and uniform, shiny, flat-topped, pale flesh-colored or reddish-brownpapules[2][3]that may appear ashypopigmentedagainst dark skin. Occasionally, minimal scaling is present or can be induced by rubbing the surface of the papules.[3]The disease usually affects children and young adults[4]and is painless and usuallynonpruritic,although protracted itching may occur in some cases.[3][5]It is sometimes referred to by dermatologists as "minilichen planus".
Presentation
[edit]Linear arrangements of these papules is common (referred to as aKoebner phenomenon), especially on the forearms,[2][5]but may occasionally be grouped, though not confluent, on flexural areas.[2]Generally, the initial lesions are localized, and remain so, to the chest, abdomen,glans penis,and flexor aspects of the upper extremities;[6]however, less commonly, the disease process can (1) be strictly isolated to the palms and soles,[7]presenting with many hyperkeratotic, yellow papules that may coalesce into plaques that fissure[3][7]or “...sometimes a non-specific keratoderma resembling chronic eczema,”[7]or (2) become more widespread, with papules widely distributed on the body—the extensor surfaces of the elbows, wrists, and hands, folds of the neck, submammary region in females, groin, thighs, ankles, and feet[1][2]—and fusing into erythematous, minimally scaled plaques, with redness that develops tints of violet, brown, and yellow.[3][4]
Pathology
[edit]
Thehistologyof lichen nitidus is significant for a "...localizedgranulomatouslymphohistiocytic infiltrate in an expandeddermal papillawith thinning of overlying epidermis and downward extension of thereteridges at the lateral margin of the infiltrate, producing a typical 'claw clutching a ball' picture.... "[1]
Treatment
[edit]Generally, lichen nitidus is asymptomatic and self-limited; therefore, no treatment is required. However, if persistent pruritus is present, or the appearance “...interferes with daily activities or outlook...”[2]topicalglucocorticoidsmay be tried. If the disease process is symptomatic, generalized and extensive, oral glucocorticoids may be indicated.[2]Other reported treatments include PUVA, UVA/UVB phototherapy,[6]astemizole,[1]acitretin,andetretinate.[2] When appears with sun/humidity; air conditioning (cool dry air) reduces swelling and discomfort.
History
[edit]Felix Pinkusfirst described the condition in 1907.[8]
See also
[edit]References
[edit]- ^abcdAl-Mutairi N, Hassanein A, Nour-Eldin O, Arun J (2005). "Generalized lichen nitidus".Pediatr Dermatol.22(2): 158–60.doi:10.1111/j.1525-1470.2005.22215.x.PMID15804308.S2CID6281902.
- ^abcdefgBerger, Timothy G.; Odom, Richard B.; Andrews, George E.; James, William D. (2000).Andrews' Diseases of the skin: clinical dermatology.Philadelphia: W. B. Saunders. pp. 277–80.ISBN0-7216-5832-6.
- ^abcdeFitzpatrick, Thomas B.; Freedberg, Irwin M. (1999).Fitzpatrick's dermatology in general medicine.New York: McGraw-Hill, Health Professions Division. pp. 577–81.ISBN0-07-912938-2.
- ^abSoroush V, Gurevitch AW, Peng SK (1999). "Generalized lichen nitidus: case report and literature review".Cutis.64(2): 135–6.PMID10467510.
- ^abMaeda M (1994). "A case of generalized lichen nitidus with Koebner's phenomenon".J. Dermatol.21(4): 273–7.doi:10.1111/j.1346-8138.1994.tb01736.x.PMID8056902.S2CID25028714.
- ^abDo MO, Kim MJ, Kim SH, Myung KB, Choi YW (2007)."Generalized Lichen Nitidus Successfully Treated with Narrow-band UVB Phototherapy: Two Cases Report".J. Korean Med. Sci.22(1): 163–6.doi:10.3346/jkms.2007.22.1.163.PMC2693559.PMID17297274.[dead link]
- ^abcThibaudeau A, Maillard H, Croué A, Belperron P, Avenel Audran M, Verret JL (2004)."[Palmoplantar lichen nitidus: a rare cause of palmoplantar hyperkeratosis.]".Ann Dermatol Venereol(in French).131(8–9): 822–4.doi:10.1016/S0151-9638(04)93769-6.PMID15505553.
- ^Crissey, John Thorne; Parish, Lawrence C.; Holubar, Karl (2002).Historical Atlas of Dermatology and Dermatologists.New York: CRC Press. p. 122.ISBN1-84214-100-7.
External links
[edit]- Lichen Nitidusat DermNet photo library