Lichen Nitidus

Question 1

Lichen Nitidus is more common in what age group?

Answer 1

• children and young adults

Question 2

Lichen Nitidus presents as:

Answer 2

• multiple/grouped pinpoint, uniform, discrete, shiny, flat-topped or umbilicated, flesh-colored papules

Question 3

Is Koebnerization common with lichen nitidus?

Answer 3

yes

Question 4

What are the favored sites for Lichen Nitidus?

Answer 4

• genitalia, lower abdomen, dorsal hands, wrists

Question 5

Histology of Lichen Nitidus:

Answer 5

• Classic “ball and claw” appearance:
• well circumscribed, superficial dermal inflammatory nodule comprised of lymphocytes, histiocytes, and giant cells confinded between two to three rete redges.
• the inflammatory infiltrate is surrounded by hyperplastic epidermal rete ridges that clasp the dermal infiltrate”

- atrophic overlying epidermis with loss of granular layer

- ball= nodule, claw=hyperplastic rete ridges

Question 7

Prognosis of lichen nitidus?

Answer 7

• majority resolve sponatenously within a year

Question 8

Treatment of Lichen Nitidus:

Answer 8

• just symptomatic tx of pruritis with TCS, TCI’s

Question 9

DDx of Lichen Nitidus:

Answer 9

- lichen spinulosis: follicular hyperkeratotic papules w/ central keratotic spine on neck, buttocks, abdomen, and upper arms

- disseminate and recurrent infundibofolliculitis: pruritic follicular-based eruption