Lichen Nitidus

Epidemiology
  • Rare
 
Pathogenesis
  • Subtype of lichen planus?
  • Separate entity due to distinctive clinical and histologic features?
 
Clinical features
  • Numerous tiny, discrete, skin-colored, uniform, pinhead-sized papules
  • Flat with shiny surface
  • Occasionally have central depression
  • Koebner phenomenon
  • Distribution
    • Flexor aspect of upper extremities
    • Chest, abdomen
    • Dorsal hands
    • Genitalia
    • Face, neck
    • Lower extremities
    • Palms and soles
    • Mucous membranes - flat, gray-white papules on the soft mucosa of mouth or white plaques on the tongue and hard palate
    • Nail - pittinh, rippling, longitudinal ridging, terminal splitting, increased linear striations
 
Histology
  • very distinctive
  • well-circunscribed lichenoid infiltrate, “clutched”by the surrounding hyperplasticrete ridges in “ball and claw” configuration
 
Treatment
  • Spontaneous clearing within on or several years
  • Primarily symptomatic
  • Topical corticosteroids
  • Oral anti-histamines
  • Topical calcineurin inhibitors
  • Phototherapy (nbUVB, PUVA)