Lichen nitidus is a noninfectious skin condition that causes the formation of papules, or raised lesions. It is often diagnosed in children and adolescents and usually resolves on its own. Treatment may include anti-inflammatory medications or phototherapy, but individuals should be aware of potential side effects.
Lichen nitidus is a chronic inflammatory disease that affects the skin, causing the formation of papules, or raised lesions, called lichenoid eruptions. Often diagnosed in children and adolescents, lichen nitidus is benign and noninfectious. Most cases of this condition require no treatment and resolve on their own. Generally, the papules fade away without leaving any lasting effects on the skin. Those seeking treatment for this condition should be aware of the risk of potential side effects.
There is no definitive cause for developing lichen nitidus. Papule formation frequently accompanies preexisting inflammatory diseases, such as lichen planus and some arthritic conditions. The conical skin lesions that characterize lichen nitidus form in response to localized inflammation.
Before a diagnosis can be confirmed, the complete medical history and symptoms are evaluated. A visual examination of the affected area is done and, in some cases, a skin biopsy may be done. Individuals who have moderate to severe lichenoid lesions may be referred to a dermatologist for further evaluation and possible treatment.
The raised lesions associated with lichen nitidus have a characteristic presentation. Commonly no larger than the head of a pin, the flat lesions usually have the same pigmentation as the surrounding skin. Typically, the development of the lesion occurs on the upper trunk and extremities, however lesions can also form on other parts of the body. Rarely, lichenoid lesions cause itching or irritation.
Acute presentations of lichen nitidus can occur following a skin lesion. Known as Koebner’s phenomenon, these lesions usually adopt a linear pattern that forms in the area directly affected by the lesion. Named for the physician who first described the abnormal condition, Koebner’s phenomenon is most frequently diagnosed in individuals with preexisting skin conditions, such as lichen planus and psoriasis.
The risk of complications related to lichen nitidus is minimal. Only in cases where the lesions induce itching is infection possible. Aggressive scratching can cause skin tears that can become vulnerable to bacteria and infection. Cases of skin inflammation accompanied by fever or oozing sores require medical attention. The most common complication associated with this chronic inflammatory disease is the impact it can have on one’s self-esteem.
Individuals experiencing itchiness may be given anti-inflammatory medications, such as a corticosteroid or antihistamine, to relieve skin irritation. The application of ultraviolet A (UVA) phototherapy can also be used to minimize the appearance of lichenoid lesions; incidentally, light therapy can cause skin irritation and itching in the short term. Before embarking on treatment for lichen nitidus, individuals should discuss the potential for side effects which can range from nausea to a long-term decrease in bone density, depending on the treatment approach.
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