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Lichen nitidus is a raredermatitis , of nameless etiology , qualify by small papules of normal peel color , with a bright surface , more often than not symptomless ( it does not get symptoms ) , locate preferably in the flexor region of the elbows , genitals , and trunk , although they can be distributed anywhere in the skin .
Its evolution over metre is variable since it can impromptu prorogue in the terminus of months to eld . So far there is no in effect treatment for the combat injury .
Lichen nitidus ( LN ) was draw and characterized by Felix Pinkus in 1901 and 1907 respectively . It is a skin rash , commonly symptomless , consisting of the presence of small papules of normal or slenderly pinkish cutis , with a undimmed surface , each one of 1 to 2 millimetre in diam , rounded , smooth and break from each other , which most often affect flock of elbow and carpus , breasts , glans , dead body of the penis and lower belly , but more seldom they can spread to any part of the body and become generalized .
How is Lichen Nitidus Treated?
The lichen nitidus is an asymptomatic and self - confine entity , which usually does not involve treatment . This is absolve in those case where there is pruritus ( itching ) or where the visual aspect and extension of the injuries spay the daily sprightliness of the patients .
Topical and systemic corticosteroid can be used with relative efficaciousness for the remission of lichen nitidus lesions .
Other treatments include psoralen , PUVA ( psolaren and ultraviolet A ) and narrow-minded - ring UVB phototherapy along with glucocorticoids and acitretin .
Call your health charge provider if small clod or a condition similar to a rash appear on the skin for no apparent reason , such as a known allergic reaction or contact lens with poison ivy . Given the number of condition that can cause cutis reaction , it is better to get a nimble and accurate diagnosis .
The mucose membranes and nails are rarely bear upon by lichen nitidus . once in a while palms and industrial plant can be compromised by presenting hyperkeratosis , fissures , erythema and the appearance of sandpaper . There are described cases of unilateral palmar presentation simulate a dyshidrotic eczematous dermatitis .
As rare variants , it can be mention the vesicular , hemorrhagic , follicular , spiny , linear , generalised and actinic types .
The clinical course is very variable with the spontaneous solvent being the most frequent , it has been described cases of remit between 1 year or less and 8 age . The papule cure without pock , although there are publication that describe a residual hyperpigmentation after the disappearance of the papule .
As it is a rare entity , there is no data sustainable in terminus of epidemiology , however , it seems to be more frequent in tyke and in the black subspecies , presumably because the clean-cut papules are more noticeable on a drear cutis , existing predominance of the female sex in the generalized strain …
The pathological figure evidences a thinned epidermis , fundamental parakeratosis , and absence seizure of granular layer , a dense lymphohistiocytic infiltrate compact , with the visual aspect of being embrace ( “ orchis and crotchet ” ) by neighbor interpapillary peak ; these determination are characteristic . In the corium , the infiltrate is well delimited composed of histiocytes and giant cells by a extraneous body ( Touton ) .
The diagnosing of the lichen nitidus is commonly simple by word structure and statistical distribution of injury ; eventually , the pathologic form will substantiate it . The differential diagnoses of lichen nitidus should be considered with :
Conclusion
The clinical course of action is unpredictable , with ad-lib resolution in months or years despite the treatment of lichen nitidus .
In most cases , it is not necessary to espouse any remedial measure since the lesions are asymptomatic and self - limiting ; only if the lesions are very blanket or symptomatic the handling with topical corticosteroids is indicated . Other treatment used in isolated cases have been tuberculostatic , antifungal and enoxaparin .
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