Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Lichen Nitidus Clinical Presentation

  • Author: Zeina Tannous, MD; Chief Editor: William D James, MD  more...
 
Updated: Jul 19, 2016
 

History

Lichen nitidus is usually an asymptomatic eruption; however, patients occasionally complain of pruritus. Familial cases have been described.[3]

Next

Physical

The primary lesions consist of multiple 1- to 3-mm, sharply demarcated, round or polygonal, flat-topped, skin-colored shiny papules that often appear in groups (see image below).

Multiple shiny lichens over the penis. Multiple shiny lichens over the penis.

The Köbner phenomenon (or an isomorphic response) may be observed, as shown below. This phenomenon causes the occasional linear pattern of the lesions associated with lichen nitidus.

Köbner phenomenon in lichen nitidus. Köbner phenomenon in lichen nitidus.

The most common sites of involvement are the trunk, flexor aspects of upper extremities, dorsal aspects of hands (see image below), and genitalia. Infrequently, the lower extremities, palms, soles, face, nails, and mucous membranes may be affected. Nail changes include pitting, ridging, splitting, and linear striations.

Lichen nitidus. Lichen nitidus.

Clinical variants of lichen nitidus include generalized,[4] linear, actinic,[5] perforating,[6, 7] keratodermic,[8, 9] vesicular,[10] and purpuric[7] /hemorrhagic[10] forms.

Reported associated diseases include atopic dermatitis,[11] lichen planus,[12] condyloma,[13] amenorrhea,[14] Crohn disease,[15, 16] , juvenile chronic arthritis,[17] and Down syndrome.[18, 19]

Previous
Next

Causes

The cause of lichen nitidus is unknown. Controversy exists regarding the relationship between lichen planus and lichen nitidus.[20]

Previous
 
 
Contributor Information and Disclosures
Author

Zeina Tannous, MD Associate Professor and Chair, Lebanese American University; Chief of Dermatology, University Medical Center, Rizk Hospital, Lebanon; Visiting Associate Professor in Dermatology, Harvard Medical School; Clinical Associate in Dermatology, Massachusetts General Hospital

Zeina Tannous, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, International Society of Cosmetic and Laser Surgeons, International Academy of Cosmetic Dermatology, Lebanese Dermatological Society, Lebanese Order of Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Warren R Heymann, MD Head, Division of Dermatology, Professor, Department of Internal Medicine, Rutgers New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

David P Fivenson, MD Associate Director, St Joseph Mercy Hospital Dermatology Program, Ann Arbor, Michigan

David P Fivenson, MD is a member of the following medical societies: American Academy of Dermatology, Michigan State Medical Society, Society for Investigative Dermatology, Photomedicine Society, Wound Healing Society, Michigan Dermatological Society, Medical Dermatology Society

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Nelly Rubeiz, MD, to the development and writing of this article.

References
  1. Bettoli V, De Padova MP, Corazza M, Virgili A. Generalized lichen nitidus with oral and nail involvement in a child. Dermatology. 1997. 194(4):367-9. [Medline].

  2. Hazen HH. Syphilis and skin diseases in the American Negro: personal observations. Arch Dermatol Syph. 1935. 31:316.

  3. Kato N. Familial lichen nitidus. Clin Exp Dermatol. 1995 Jul. 20(4):336-8. [Medline].

  4. Al-Mutairi N, Hassanein A, Nour-Eldin O, Arun J. Generalized lichen nitidus. Pediatr Dermatol. 2005 Mar-Apr. 22(2):158-60. [Medline].

  5. Glorioso S, Jackson SC, Kopel AJ, Lewis V, Nicotri T Jr. Actinic lichen nitidus in 3 African American patients. J Am Acad Dermatol. 2006 Feb. 54(2 Suppl):S48-9. [Medline].

  6. Itami A, Ando I, Kukita A. Perforating lichen nitidus. Int J Dermatol. 1994 May. 33(5):382-4. [Medline].

  7. Yoon TY, Kim JW, Kim MK. Two cases of perforating lichen nitidus. J Dermatol. 2006 Apr. 33(4):278-80. [Medline].

  8. Munro CS, Cox NH, Marks JM, Natarajan S. Lichen nitidus presenting as palmoplantar hyperkeratosis and nail dystrophy. Clin Exp Dermatol. 1993 Jul. 18(4):381-3. [Medline].

  9. Yáñez S, Val-Bernal JF. Purpuric generalized lichen nitidus: an unusual eruption simulating pigmented purpuric dermatosis. Dermatology. 2004. 208(2):167-70. [Medline].

  10. Jetton RL, Eby CS, Freeman RG. Vesicular and hemorrhagic lichen nitidus. Arch Dermatol. 1972 Mar. 105(3):430-1. [Medline].

  11. Lestringant GG, Piletta P, Feldmann R, Galadari I, Frossard PM, Saurat JH. Coexistence of atopic dermatitis and lichen nitidus in three patients. Dermatology. 1996. 192(2):171-3. [Medline].

  12. Kawakami T, Soma Y. Generalized lichen nitidus appearing subsequent to lichen planus. J Dermatol. 1995 Jun. 22(6):434-7. [Medline].

  13. Scheinfeld NS, Lehman D. Condyloma with lichen nitidus. Skinmed. 2005 May-Jun. 4(3):177-8. [Medline].

  14. Taniguchi S, Chanoki M, Hamada T. Recurrent generalized lichen nitidus associated with amenorrhea. Acta Derm Venereol. 1994 May. 74(3):224-5. [Medline].

  15. Kano Y, Shiohara T, Yagita A, Nagashima M. Erythema nodosum, lichen planus and lichen nitidus in Crohn's disease: report of a case and analysis of T cell receptor V gene expression in the cutaneous and intestinal lesions. Dermatology. 1995. 190(1):59-63. [Medline].

  16. Scheinfeld NS, Teplitz E, McClain SA. Crohn's disease and lichen nitidus: a case report and comparison of common histopathologic features. Inflamm Bowel Dis. 2001 Nov. 7(4):314-8. [Medline].

  17. Bercedo A, Cabero MJ, Garcia-Consuegra J, Hernado M, Yaez S, Fernandez-Llaca H. Generalized lichen nitidus and juvenile chronic arthritis: an undescribed association. Pediatr Dermatol. 1999 Sep-Oct. 16(5):406-7. [Medline].

  18. Henry M, Metry DW. Generalized lichen nitidus, with perioral and perinasal accentuation, in association with Down syndrome. Pediatr Dermatol. 2009 Jan-Feb. 26(1):109-11. [Medline].

  19. Botelho LF, Magalhães JP, Ogawa MM, Enokihara MM, Cestari Sda C. Generalized Lichen nitidus associated with Down's syndrome: case report. An Bras Dermatol. 2012 May-Jun. 87(3):466-8. [Medline].

  20. Cho EB, Kim HY, Park EJ, Kwon IH, Kim KH, Kim KJ. Three cases of lichen nitidus associated with various cutaneous diseases. Ann Dermatol. 2014 Aug. 26(4):505-9. [Medline]. [Full Text].

  21. Dobbs CR, Murphy SJ. Lichen nitidus treated with topical tacrolimus. J Drugs Dermatol. 2004 Nov-Dec. 3(6):683-4. [Medline].

  22. Park J, Kim JI, Kim DW, Hwang SR, Roh SG, Kim HU, et al. Persistent generalized lichen nitidus successfully treated with 0.03% tacrolimus ointment. Eur J Dermatol. 2013 Nov-Dec. 23(6):918-9. [Medline].

  23. Sehgal VN, Jain S, Kumar S, et al. Generalized lichen nitidus in a child's response to cetirizine dihydrochloride/levamisol. Australas J Dermatol. 1998 Feb. 39(1):60. [Medline].

  24. Lucker GP, Koopman RJ, Steijlen PM, van der Valk PG. Treatment of palmoplantar lichen nitidus with acitretin. Br J Dermatol. 1994 Jun. 130(6):791-3. [Medline].

  25. Libow LF, Coots NV. Treatment of lichen planus and lichen nitidus with itraconazole: reports of six cases. Cutis. 1998 Nov. 62(5):247-8. [Medline].

  26. Kano Y, Otake Y, Shiohara T. Improvement of lichen nitidus after topical dinitrochlorobenzene application. J Am Acad Dermatol. 1998 Aug. 39(2 Pt 2):305-8. [Medline].

  27. Randle HW, Sander HM. Treatment of generalized lichen nitidus with PUVA. Int J Dermatol. 1986 Jun. 25(5):330-1. [Medline].

  28. Do MO, Kim MJ, Kim SH, Myung KB, Choi YW. Generalized lichen nitidus successfully treated with narrow-band UVB phototherapy: two cases report. J Korean Med Sci. 2007 Feb. 22(1):163-6. [Medline].

  29. Kim YC, Shim SD. Two cases of generalized lichen nitidus treated successfully with narrow-band UV-B phototherapy. Int J Dermatol. 2006 May. 45(5):615-7. [Medline].

  30. Park JH, Choi YL, Kim WS, et al. Treatment of generalized lichen nitidus with narrowband ultraviolet B. J Am Acad Dermatol. 2006 Mar. 54(3):545-6. [Medline].

 
Previous
Next
 
Multiple skin-colored shiny papules associated with lichen nitidus.
Multiple shiny lichens over the penis.
Köbner phenomenon in lichen nitidus.
Lichen nitidus.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.