eMedicine Specialties > Dermatology > Reactive & Inflammatory Dermatoses

Lichen Nitidus: Differential Diagnoses & Workup

Author: Zeina Tannous, MD, Consulting Staff, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School
Coauthor(s): Nelly Rubeiz, MD, Consulting Staff, Department of Dermatology, American University of Beirut Medical Center; Associate Professor, Department of Dermatology, American University of Beirut, Lebanon
Contributor Information and Disclosures

Updated: Mar 20, 2008

Differential Diagnoses

Amyloidosis, Lichen
Lichen Striatus
Bowenoid Papulosis
Psoriasis, Guttate
Id Reaction (Autoeczematization)
Sarcoidosis
Keratosis Pilaris
Warts, Nongenital
Lichen Planus
Lichen Sclerosus et Atrophicus
Lichen Spinulosus

Other Problems to Be Considered

Lichen scrofulosorum

Workup

Procedures

A skin biopsy for histopathologic examination may be obtained to confirm the clinical diagnosis.

Histologic Findings

The papule of lichen nitidus consists of a lymphohistiocytic inflammatory cell infiltrate that lies in close proximity to the epidermis and is associated with basal cell hydropic degeneration. The overlying epidermis is flattened and parakeratotic. At the lateral margins of the papule, the rete ridges extend downward and seem to hug the inflammatory infiltrate, which may be granulomatous.

More on Lichen Nitidus

Overview: Lichen Nitidus
Differential Diagnoses & Workup: Lichen Nitidus
Treatment & Medication: Lichen Nitidus
Follow-up: Lichen Nitidus
Multimedia: Lichen Nitidus
References
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References

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Further Reading

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Keywords

flat-topped lesions, Köbner phenomenon, Koebner phenomenon, isomorphic response

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Contributor Information and Disclosures

Author

Zeina Tannous, MD, Consulting Staff, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School
Zeina Tannous, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Coauthor(s)

Nelly Rubeiz, MD, Consulting Staff, Department of Dermatology, American University of Beirut Medical Center; Associate Professor, Department of Dermatology, American University of Beirut, Lebanon
Nelly Rubeiz, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Medical Editor

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, Medical Dermatology Society, Michigan Dermatological Society, Michigan State Medical Society, Photomedicine Society, Society for Investigative Dermatology, and Wound Healing Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Warren R Heymann, MD, Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey
Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

 
 
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