Lichen nitidus: a histologic and electron microscopic study.

A lesion of lichen nitidus in a 53-year-old man was examined by histology and electron microscopy. The histology showed typical features. The electron microscopy revealed primary changes in hydropic degeneration of basal cells which possibly indicated severe edema between the basal keratinocytes and in the subepidermal area. The basal keratinocytes themselves were not particularly altered, except for clustered micro-vacuolar structures in a small portion of the peripheral cytoplasm. In one of the eight blocks observed, the cytoplasmic process of a mast cell was found between the basal keratinocytes, indicating that mast cells may possibly infiltrate the epidermis in lichen nitidus. Scattered mast cells in the dermis were also noted. Thus primary pathologic changes of lichen nitidus may be induced by severe edema, which was accompanied by inflammatory cells including mast cells, in the region of the dermal-epidermal junction.     

Lichen nitidus of the palms: a case with peculiar histopathologic features

Palmar involvement in lichen nitidus is infrequent. In such cases, the histopathologic findings of palmar lesions are usually identical to those of extrapalmar ones. We report on the case of a patient with multiple tiny papules located on the palms and elbows. A biopsy specimen from the elbow showed the typical features of lichen nitidus, but a biopsy from the palm disclosed an inflammatory infiltrate mostly disposed around the bases of rete ridges and composed of lymphocytes and histiocytes with some giant cells both in the dermis and in the epidermis. This location of the infiltrate is similar to that found in hypertrophic lichen planus, a combination of lichen planus and lichen simplex chronicus. We conclude that this histopathologic feature in palmar lichen nitidus could be the result of the superimposition of lichen nitidus on normal palmar skin, resulting in a picture resembling hypertrophic lichen planus.     

Generalized lichen nitidus

Lichen nitidus is a rare chronic condition of unknown etiology. Generalized lichen nitidus is even rarer. We report here a 5-year-old girl who had multiple, asymptomatic, discrete, 1 to 2 mm flesh-colored, shiny, flat, papules on her face, upper limbs, and thighs with relative sparing of the trunk. Resolution of these papular lesions was followed by hyperpigmented macules in those areas. Histopathologic examination of a papular lesion revealed a localized granulomatous lymphohistiocytic infiltrate in an expanded dermal papilla with thinning of overlying epidermis and downward extension of the rete ridges at the lateral margin of the infiltrate, producing a typical "claw clutching a ball" picture, confirming our clinical diagnosis of lichen nitidus. The pigmented macules showed melanin pigmentation on histology. There was no response to oral astemizole treatment for 3 months. However, the lichen nitidus lesions resolved spontaneously without any further treatment over the next year, leaving behind a prominent pigmentary disturbance.     

Palmoplantar lichen nitidus: a rare cause of palmoplantar hyperkeratosis

BACKGROUND: Lichen nitidus is a rare condition, which may be a cause of palmoplantar hyperkeratosis. We report two cases. CASE REPORTS: A 53 year-old woman presented with a dry and fissured palmoplantar hyperkeratosis. Histological examination of a biopsy showed the typical features of lichen nitidus. Significant improvement was obtained with acitretin. A few months later, multiple lichen nitidus papules appeared on the limbs and the abdomen. A 67 year-old woman was referred to us for a fissured, disabling palmoplantar hyperkeratosis refractory to topical steroids. Histological examination led to the diagnosis of lichen nitidus. Local PUVA therapy resulted in the cleaning of her lesions. Later, typical papules of lichen nitidus appeared on her elbows. DISCUSSION: Nineteen cases of palmoplantar localization of lichen nitidus have been described. The features are usually tiny yellow papules but sometimes a non-specific keratoderma resembling chronic eczema. Palmoplantar involvement of lichen nitidus may be isolated or associated with cutaneous lesions on unusual sites. Oral retinoids and local PUVA are effective treatments.     

Periappendageal lichen nitidus: report of a case

BACKGROUND: The histology of lichen nitidus has been described previously but a follicular variant has not been emphasized. METHOD: We report a case of lichen nitidus with periappendageal inflammation resulting in histologic similarities to lichen striatus. RESULTS: This case extends the spectrum of histologic findings in lichen nitidus and shows overlap in the distribution of the inflammatory infiltrate in lichen nitidus and lichen striatus.     

Lichen Nitidus Presenting with Nail Changes—Case Report and Review of the Literature

Lichen nitidus of the nail is rare and can precede the onset of skin lesions. Delayed diagnosis is common. We present an unusual case of lichen nitidus–associated nail changes that preceded the onset of skin lesions in a 4‐year‐old Indian girl. We also conduct a review of six other cases of lichen nitidus with nail involvement from the English‐language literature. Clues to the diagnosis of lichen nitidus include violaceous or pigmentary changes of the nail fold and subtle lichenoid papules on the affected digits. Lichen nitidus of the nails appears to be less severe than nail changes of lichen planus and is generally self‐limiting. Understanding the natural history of lichen nitidus of the nails will help physicians better counsel patients and their families.     

Two cases of perforating lichen nitidus

Lichen nitidus is an unusual condition that usually affects children and young adults. Of its many variants, a perforating type has been rarely reported. We herein report two cases of lichen nitidus with perforation. Two young women in good health presented with multiple shiny papules that seems to be typical lichen nitidus clinically, but some of the papules were umbilicated. Histopathological examination revealed the typical findings of lichen nitidus with perforation in both cases.     

A very rare localization of a rare disease: palmar lichen nitidus

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.     

光泽苔藓的皮肤三维CT特征

目的 探讨皮肤三维CT在光泽苔藓诊断中的应用.方法应用皮肤三维CT技术对5例临床表现典型的光泽苔藓患者进行检测,并与5例毛发苔藓患者的检测结果进行比较.结果皮肤三维CT检测结果发现,光泽苔藓患者病灶部位可见表皮轻度萎缩,真皮乳头增宽,增宽的真皮乳头内可见密集单一核细胞浸润,而毛发苔藓患者病灶部位可见毛囊口扩张,毛囊口内含有角质栓.结论皮肤三维CT有望成为光泽苔藓可选择的实验室诊断方法之一.     

Actinic lichen nitidus

Actinic lichen nitidus is a unique photoinduced lichenoid eruption that displays histologic features of classic lichen nitidus, with some clinical similarity. It is seen most commonly in deeply pigmented patients (Fitzpatrick skin types V and VI), in photodistributed areas, and during the summer months. Sun avoidance and topical corticosteroids are the mainstay of therapy; however, seasonal recurrences are common. Actinic lichen nitidus has unique properties that differentiate it from classic lichen nitidus. Confusion exists in the literature regarding the nomenclature of this entity, and it appears to be an underrecognized disease in the United States.     

Generalized Lichen Nitidus Appearing Subsequent to Lichen Planus

A 27-year-old man was seen with multiple, small, shiny papules on his shoulders, upper arms, and trunk, and hyperpigmented violaceous plaques on his feet. The former was diagnosed as generalized lichen nitidus and the latter, as lichen planus. It is not likely that the coexistence of the two diseases in this patient is a fortuitous one, since generalized lichen nitidus is a very rare condition. The association of lichen nitidus and lichen planus suggests that lichen nitidus is closely related to lichen planus and that the two diseases may be different manifestations of essentially the same pathogenetic process.     

Lichen nitidus presenting as palmoplantar hyperkeratosis and nail dystrophy

Four patients with lichen nitidus who presented with palmoplantar or nail lesions arc reported. In three cases palmoplantar hyperkeratosis was marked; these cases also had nail-plate lesions, but in all four, lesions of lichen nitidus at other sites were absent, sparse or asymptomatic.     

Treatment of Generalized Lichen Nitidus with PUVA

Generalized lichen nitidus refractory to topical and systemic corticosteroids completely responded to PUVA. The similarity of lichen nitidus to lichen planus and the presumed lymphocytotoxic effect of PUVA were the bases for our use of oral photochemotherapy.     

Two cases of generalized lichen nitidus treated successfully with narrow-band UV-B phototherapy

BACKGROUND: Narrow-band ultraviolet (UV) phototherapy has not been used in the treatment of lichen nitidus. AIM: To report two cases of generalized lichen nitidus successfully treated with narrow-band UV-B phototherapy. METHODS: A 7-year-old girl presented with a persisting, asymptomatic, papular eruption refractory to topical steroid for 3 months. Another 10-year-old boy presented with an asymptomatic papular eruption present for 6 months. The histopathologies of both lesions were consistent with lichen nitidus. The lesions were treated with narrow-band UV-B phototherapy. RESULTS: The lesions of the patients were almost completely cleared after the 30th and the 17th irradiation, respectively. CONCLUSIONS: Narrow-band UV-B may be an effective alternative therapy for the treatment of generalized lichen nitidus unresponsive to common therapies.     

An unusual variant of lichen nitidus: Generalized follicular spinous with perifollicular granulomas

Several unusual variants of lichen nitidus are described in the literature. Spinous follicular lichen nitidus with perifollicular granulomas is one such variant characterized by generalized follicular as well as nonfollicular keratotic papules, which show perifollicular granulomas on histopathology as well as a lichenoid granulomatous tissue reaction typical of lichen nitidus. Owing to its atypical clinical and histopathologic manifestations, it raises several clinical possibilities and can be a diagnostic challenge. We report this rare variant of lichen nitidus in a 19-year-old female, and discuss its clinical and histopathological differential diagnosis.     

Lichen nitidus associated with distinctive nail changes

We report a case of lichen nitidus with nail changes, occurring in a young girt. The relationship between lichen nitidus and lichen planus is discussed, with particular regard to the associated nail changes.     

Generalized Spinous Follicular Lichen Nitidus with Perifollicular Granulomas

Abstract: The first report of spinous follicular lichen nitidus with perifollicular granulomas was by Madhok and Winkelmann in 1988. Since this report, a few cases of follicular or periappendageal lichen nitidus have been described, in a more localized form or without perifollicular granulomas. We describe a 5‐year‐old girl with the rare generalized spinous follicular variant of lichen nitidus with perifollicular granulomas.     

Pediatric generalized lichen nitidus treated with natural sunlight therapy

Lichen nitidus is a benign inflammatory dermatosis that typically presents in a localized distribution. We present the rare case of a 6‐year‐old boy with a 1‐year history of generalized lichen nitidus with limited access to narrowband ultraviolet B phototherapy. Over the course of a summer, he had complete and lasting resolution of generalized lichen nitidus after daily natural sunlight exposure. This case demonstrates a rare variant of lichen nitidus and a practical treatment alternative to in‐office phototherapy.     

Purpuric palmar lichen nitidus–an unusual though distinctive eruption

Lichen nitidus is usually regarded as an eruption characterized by multiple flesh-coloured domed papules occurring on the limbs, trunk or genitalia of children or young adults. A case of a distinctive but unusual ‘purpuric’ palmar lichen nitidus is described in a middle-aged adult. The range of the clinical appearance of palmoplantar lichen nitidus is reviewed.     

光泽苔藓的共聚焦激光扫描显微镜下特征

目的对光泽苔藓的共聚焦激光扫描显微镜(CLSM)特征进行初步探索。方法选取在本院就诊的27例临床诊断为光泽苔藓的患者,每位患者挑选一处皮损先行CLSM检查,后取该处皮损行常规组织病理检查。同时在该皮损附近正常皮肤处行CLSM检查,进行对照。结果与周围正常皮肤相比,皮损处CLSM图像可观察到真皮乳头部散在分布局限性炎细胞浸润灶,其主要由组织细胞和淋巴细胞组成,下延的表皮突环抱浸润灶。结论光泽苔藓的CLSM图像有一定的特征性,可为该病的诊断和鉴别诊断提供有效的帮助。