ABSTRACT
Abstract Lichen nitidus is an uncommon lichenoid dermatosis that could be defined as multiple, separated, shiny, pinpoint, pale to skin-colored papules. Palmoplantar lichen nitidus is a quite rare variant of lichen nitidus. It is hard to make a diagnosis of palmar lichen nitidus when there are no lesions elsewhere on the body. There are some dermoscopic features defined for both palmoplantar and non-palmoplantar lichen nitidus that might be useful to facilitate the diagnosis before histopathological examination. Herein, we report a case of a 24-year-old man diagnosed with isolated palmar lichen nitidus with dermoscopic features and histopathological confirmation.
Subject(s)
Humans , Male , Adult , Young Adult , Rare Diseases , Lichen Nitidus/diagnostic imagingABSTRACT
@#A 32-year-old Filipino male managed as a case of acute myeloid leukemia presented with a 6-month history of generalized, red-brown papules. After chemotherapy, the patient was advised 30-minutes daily sun exposure as a form of natural phototherapy. On follow-up, most lesions flattened. This case demonstrates chemotherapy’s potential role in controlling the patient’s inflammatory state and using ultraviolet light therapy in the form of sunlight to manage generalized purpuric lichen nitidus.
Subject(s)
Lichen Nitidus , Dermoscopy , PhototherapyABSTRACT
Background: Facial papules are a feature of several clinical conditions and may present both diagnostic and therapeutic challenges. Aim: To describe a grouped papular eruption on the nose and adjoining cheeks that has not been well characterized previously. Materials and Methods: A series of consecutive patients with a papular eruption predominantly involving nose and cheeks were evaluated, treated and followed up prospectively at tertiary care centers. Demographic details, clinical features, histopathology and response to treatment were recorded. Results: There were five men and six women (mean age 29.9 ± 6.9 years) who had disease for a mean duration of 17.3 ± 11.1 months. All patients presented with a predominantly asymptomatic eruption of monomorphic, pseudovesicular, grouped, skin colored to slightly erythematous papules prominently involving the tip of nose, nasal alae, philtrum and the adjoining cheeks. A total of 15 biopsies from 11 patients were analyzed and the predominant finding was a dense, focal lymphoid infiltrate restricted to the upper dermis with basal cell damage and atrophy of the overlying epidermis. The eruption ran a chronic course from several months to years. Limitations: Direct immunofluorescence could not be performed except in one case. Immunohistochemical stains for CD4 and CD8 could not be done owing to nonavailability. Phototesting was undertaken in one patient only. Conclusion: Small grouped papules on the nose and adjoining skin with a lichenoid histopathology appear to represent a distinct clinicopathological entity. It may be related to actinic lichen nitidus/micropapular variant of polymorphous light eruption.
ABSTRACT
Lichen nitidus (LN) is an uncommon, usually asymptomatic cutaneous eruption characterized by the presence of multiple, small, flesh-colored papules. The epidemiologic and pathophysiologic characteristics of LN have not yet been defined. Furthermore, LN has rarely been described in association with other cutaneous diseases. We herein report 3 cases of LN associated with various cutaneous diseases, including lichen striatus, oral lichen planus, and psoriasis vulgaris.
Subject(s)
Lichen Nitidus , Lichen Planus , Lichen Planus, Oral , Lichens , Mouth , PsoriasisABSTRACT
Generalized lichen nitidus is an uncommon chronic inflammatory dermatosis with very characteristic histological findings. Its pathogenesis is still unclear; very rarely it has been associated with genetic disorders. Herein we report the case of a 12-year-old boy with Niemann-Pick disease who developed generalized lichen nitidus.
Líquen nítido generalizado é uma dermatose inflamatória crônica, rara, com achados histológicos muito característicos. Sua patogênese não está completamente esclarecida e, muito raramente, tem sido associado a doenças genéticas. Reportamos o caso de um doente do sexo masculino, de 12 anos de idade, com Doença de Niemann-Pick, que desenvolveu líquen nítido generalizado.
Subject(s)
Child , Humans , Male , Lichen Nitidus/genetics , Niemann-Pick Disease, Type B/complications , Chronic Disease , Lichen Nitidus/pathology , Niemann-Pick Disease, Type B/pathology , Skin/pathologyABSTRACT
El granuloma anular es una enfermedad granulomatosa benigna con diferentes manifestaciones clínicas que incluye la forma localizada, generalizada, perforante, subcutánea, en parche, papular y lineal. El granuloma anular papular umbilicado es considerado una variante de la forma papular y en la literatura anglosajona se han reportado muy pocos casos. Se presenta el caso de un adolescente con pápulas eucrómicas asintomáticas en el dorso de las manos desde la infancia. La biopsia sugirió liquen nitidus, posteriormente la correlación clínico-patológica permitió hacer diagnóstico de granuloma anular papular umbilicado. Se resalta la importancia de este diagnóstico diferencial y la cronicidad de las lesiones.
The granuloma annulare is a benign granulomatous disease with different clinical manifestations including, localized, generalized, perforating, subcutaneous, patch type, papular and linear types. Papular umbilicated granuloma annulare is considered to be a variant of the papular type and in the Anglo-Saxon literature very few cases have been reported. We describe the case of an adolescent with asymptomatic skin colored papules on the dorsal aspect of the hands since infancy. The biopsy suggested lichen nitidus and after the clinicopathological correlation the diagnosis of papular umbilicated granuloma annulare was made. We highlight the importance of this differential diagnosis and the chronicity of the lesions.
O granuloma anular é uma doença granulomatosa benigna com diferentes manifestações clínicas que inclui a forma localizada, generalizada, perfurante, subcutânea, em parche, papular e linear. O granuloma anular papular umbilicado é considerado uma variante da forma papular e na literatura anglo-saxã foram relatados muito poucos casos. Apresenta-se o caso de um adolescente com pápulas acrômicas assintomáticas no dorso das mãos desde a infância. A biopsia sugeriu líquen nitidus, posteriormente a correlação clínico-patológica permitiu fazer diagnóstico de granuloma anular papular umbilicado. Destaca-se a importância deste diagnóstico diferencial e a cronicidade das lesões.
Subject(s)
Humans , Adolescent , Granuloma Annulare , Pathology , Adolescent , Lichen NitidusABSTRACT
Lichen nitidus is a disease of unknown etiology, characterized by flesh-colored, shiny papules of 1-2 mm and generally asymptomatic or with mild pruritus. The most common sites of occurrence are genitalia, upper limbs, trunk and abdomen. The generalized form is rare. This is the fourth reported case of lichen nitidus associated with Down Syndrome.
Líquen nítido é uma doença de etiologia desconhecida, caracterizada por pápulas normocrômicas, brilhantes medindo de 1 a 2 milímetros de diâmetro, geralmente assintomáticas ou com leve prurido. A forma mais comum é a localizada nos genitais, membros superiores, tronco e abdome. A forma generalizada é rara. Este é o quarto relato de caso descrito de líquen nítido associado à Síndrome de Down.
Subject(s)
Child, Preschool , Female , Humans , Down Syndrome/complications , Lichen Nitidus/complications , Lichen Nitidus/pathologyABSTRACT
Perforating lichen nitidus is an unusual variant of lichen nitidus. It is clinically characterized by umbilicated papules and histopathologically characterized by transepidermal elimination of inflammatory debris from granulomatous infiltrates. Most cases of perforating lichen nitidus are treated with topical corticosteroids, but long-term use of topical corticosteroids could provoke several side effects. Herein, we report a case of perforating lichen nitidus treated effectively and safely with topical tacalcitol ointment. We performed a dermoscopic examination for the perforating lichen nitidus lesion and found the characteristic "frogspawn" dermoscopic feature.
Subject(s)
Adrenal Cortex Hormones , Dermoscopy , Dihydroxycholecalciferols , Lichen Nitidus , LichensABSTRACT
Líquen nítido é uma dermatose rara, caracterizada por pápulas arredondadas normocrômicas de diâmetro, variando entre 1-2 mm, e geralmente assintomáticas. Sem predileção por sexo ou raça, acomete, principalmente, crianças e adultos jovens, na maioria dos casos, possuindo curso clínico imprevisível e tendendo à regressão espontânea, anos após o início da doença. As lesões são em geral localizadas, mas raros relatos da doença cursando com lesões disseminadas existem.
Lichen nitidus is a rare dermatosis, characterized by round, skin-colored papules whose size varies between 1-2 mm and are generally asymptomatic. It does not have predilection for gender or race, affecting mainly children and young adults. Its clinical course is unpredictable, but most cases tend to spontaneously regress years after the onset of the disease. Lesions are often localized, but rare reports of disseminated disease exist.
Subject(s)
Child , Humans , Male , Lichen Nitidus/pathologyABSTRACT
Lichen planus (LP) and lichen nitidus (LN) present with varied morphology on the palms and soles. We present four unusual cases of palmoplantar LP and LN manifesting as hyperkeratotic plaques with pits. The diagnosis was confirmed histologically. Subtle features like presence of violaceous border suggests LP and plugs within the pits suggest LN.
ABSTRACT
Lichen planus is an unique, common inflammatory disorder that affects the skin, mucous membranes, nails and hair. Oral lichen planus is among the more common mucosal conditions with an unknown etiology. Lichen nitidus is an uncommon, usually asymptomatic cutaneous eruption that is characterized by the presence of multiple, small, flesh colored papules. Perforation in lichen nitidus is a rare phenomenon. Lichen nitidus is distinguished from lichen planus on both clinical and histologic grounds. However, the possibility that lichen nitidus represents a micropapular variant of lichen planus has never been definitively excluded. Herein, we report on a case of perforating lichen nitidus associated with oral lichen planus.
Subject(s)
Hair , Lichen Nitidus , Lichen Planus , Lichen Planus, Oral , Lichens , Mucous Membrane , Nails , SkinABSTRACT
Lichen nitidus (LN) is an uncommon chronic eruption of an unknown cause, and it is characterized by tiny, discrete, flesh-colored papules. The sites of predilection are the genitalia, trunk and extremities. Unilateral palmar involvement with pruritus is infrequent. We report here on a case of LN confined to the right palm, and the patient presented with multiple, pruritic, erythematous to flesh-colored, tiny papules and vesicles that mimicked pompholyx. The histopathological examination of a skin biopsy specimen showed the typical findings of LN.
Subject(s)
Humans , Biopsy , Eczema, Dyshidrotic , Extremities , Genitalia , Lichen Nitidus , Lichens , Pruritus , SkinABSTRACT
Generalized lichen nitidus is a rare subtype of lichen nitidus, and the former condition is characterized by multiple, shiny flesh-colored pin-head sized papules that occur over the entire body. Generalized lichen nitidus is often associated with various degrees of pruritus and the clinical course tends to be chronic in contrast with the other forms of lichen nitidus. We report here on a case of a 39-year-old man who was diagnosed with generalized lichen nitidus that developed after a subcutaneous insulin injection. He was treated with topical corticosteroid.
Subject(s)
Adult , Humans , Diabetes Mellitus , Insulin , Lichen Nitidus , Lichens , PruritusABSTRACT
Lichen nitidus is a rare chronic inflammatory disease that was first described by Pinkus in 1907. It is characterized by asymptomatic multiple minute, flesh-colored, shiny dome shaped papules that occur on the abdomen, chest, extremities and genitalia of children or young adults. This disorder is most often localized and only a few cases of generalized lichen nitidus have been reported. Because lichen nitidus tends to be asymptomatic and it spontaneously resolves within several years, it usually does not require treatment except in the symptomatic, persistent and generalized cases. We report here on a case of a 27-year-old woman who was diagnosed with lichen nitidus, and her condition was refractory to general treatment. She was successfully treated with the application of 0.03% tacrolimus ointment.
Subject(s)
Adult , Child , Female , Humans , Young Adult , Abdomen , Extremities , Genitalia , Lichen Nitidus , Lichens , Tacrolimus , ThoraxABSTRACT
Lichen nitidus is an uncommon, asymptomatic cutaneous shiny papular eruption and it can rarely show Koebner's phenomenon, which may clinically resemble lichen striatus. It is known that for such cases, the clinicopathological correlation is the most important factor for making the diagnosis and immunohistochemical staining for CD4, CD8 and CD68 can be helpful to differentiate these two diseases. We experienced a case of Koebner phenomenon, which clinically mimicked lichen striatus, in a patient suffering with lichen nitidus.
Subject(s)
Humans , Lichen Nitidus , Lichens , Stress, PsychologicalABSTRACT
BACKGROUND: Generalized lichen nitidus is a rare subtype of lichen nitidus characterized by multiple, flesh-colored, shiny papules occurring over the entire body. OBJECTIVE: We investigated the clinical features of generalized lichen nitidus in patients followed up at our institution. METHODS: The patients with generalized lichen nitidus diagnosed clinically and histopathologically between 1998 and 2007 were reviewed. RESULTS: Twelve patients (9 males and 3 females) were enrolled in this study and the mean age at onset was 10.3 (range: 4~27) years. Of the 12 patients, 5 (41.7%) experienced pruritus and 4 (33.3%) had atopic dermatitis. None of the patients had a family history of lichen nitidus. Nine patients were treated with topical steroids, systemic steroids, oral antihistamines, or narrow-band UVB. We propose that narrow band UVB is an effective treatment modality for generalized lichen nitidus. The mean duration to clearance was 37.7 (range: 7~120) months and the disease was relapsing in 2 patients. The duration to clearance was correlated to the age at onset (p=0.0005) and to the duration at the first visit (p=0.0000), whereas it was not related to the sex of the patient, pruritus or the accompanying atopic dermatitis. CONCLUSION: Generalized lichen nitidus is often associated with varying degrees of pruritus and the clinical course of the disease tends to be chronic. We propose that onset at an early age and the short duration of disease at the first visit are good prognostic factors, and that narrow band UVB is an effective treatment modality for generalized lichen nitidus.
Subject(s)
Humans , Male , Dermatitis, Atopic , Histamine Antagonists , Lichen Nitidus , Lichens , Pruritus , SteroidsABSTRACT
Lichen nitidus (LN) is an uncommon chronic inflammatory skin disease composed of numerous, tiny, shiny, flesh-colored papules that are predominantly observed on the chest, abdomen, glans penis and upper extremities. The distribution of LN is most often localized, but in some cases it can become generalized. Because LN tends to be asymptomatic and presents spontaneous resolution within several years, it usually does not require treatment except in symptomatic, persistent and generalized cases. We describe a 28-yr-old man and a 7-yr-old boy with generalized LN where both cases improved with narrow-band ultraviolet B (NB-UVB) phototherapy plus topical steroid ointment. Both patients noted improvement within the first three treatments and showed almost complete resolution after 18 and 20 treatments, respectively. NB-UVB phototherapy may be an effective alternative therapy for the treatment of generalized LN, even for those patients in their childhood.