Lichen nitidus

Definition

Lichen nitidus (LIE-kun ni-TI-dus) is a rare skin condition that usually appears as tiny, skin-colored, glistening bumps on the surface of your skin. Lichen nitidus results from abnormal inflammatory activity in skin cells, but the cause of inflammation is unknown.

Although lichen nitidus may affect anyone, it typically develops in children and young adults. Lichen nitidus rarely causes discomfort and usually clears up on its own without treatment.

Lichen nitidus isn't a form of cancer, doesn't increase your risk of skin cancer, and isn't an infectious disease that can spread to other people.

Lichen nitidus

Lichen nitidus

Lichen nitidus is an uncommon, inflammatory skin condition. It appears as small, skin-colored, raised bumps (papules). ...

Symptoms

Lichen nitidus appears as clusters of tiny, glistening bumps (papules). Characteristics of the papules include the following:

Size

• Pinpoint to pinhead size

Shape

• Flat
• Round

Color

• Usually the same as your normal skin color
• Sometimes slightly pink on people with lighter skin
• Sometimes lighter than normal skin color on people with darker skin

Location
The most common locations of lichen nitidus papules include:

• Chest and abdomen
• Arms
• Tip of penis (glans) or shaft of penis
• Other skin around the genitals
• Rarely, on the palms, soles of the feet, mucous membranes and fingernails

In rare cases, the papules of lichen nitidus itch. The papules may appear in a line where there's a scratch, crease or constant pressure on the skin, such as a fold of skin on the abdomen or the crease of skin on the inside of the elbow or wrist. Lichen nitidus may clear up at one site on your body but appear at another.

When to see a doctor
See your doctor if tiny bumps or a rash-like condition appears on your skin for no apparent reason, such as a known allergic reaction or contact with poison ivy. Because a number of conditions can cause skin reactions, it's best to get a prompt and accurate diagnosis.

Get immediate care if your skin condition is accompanied by other signs and symptoms, such as:

• Fever
• Itching
• Pus or oozing from a rash

Lichen nitidus

Lichen nitidus

Lichen nitidus is an uncommon, inflammatory skin condition. It appears as small, skin-colored, raised bumps (papules). ...

Causes

The cause of lichen nitidus is unknown. The papules that appear are the result of inflammation controlled by white blood cells called T lymphocytes. Normally, these cells are active at the site of disease or injury. Doctors and researchers don't know what prompts T lymphocytes to be activated in lichen nitidus.

Association with other diseases
Because lichen nitidus is rare, most information about the disorder is known from individual cases or very small studies, rather than large studies, which generally produce more reliable information. Therefore, possible associations observed between lichen nitidus and other diseases aren't well understood.

Reports from individual cases and small studies have found lichen nitidus associated with:

• Lichen planus, an inflammatory condition usually characterized by patches of red or purple, flat-topped, itchy bumps on the skin or lacy white patches on the mucous membranes of the mouth
• Atopic dermatitis (eczema), an inflammatory skin condition usually characterized by dry, itchy, rashes on the face, inside the elbow, behind the knees, and on the hands and feet
• Crohn's disease, inflammation of the lining of your digestive tract, which can lead to abdominal pain, severe diarrhea and malnutrition
• Juvenile rheumatoid arthritis, an inflammatory disease that causes persistent joint pain, swelling and stiffness
• Tuberculosis, an infectious disease that most often affects the lungs

Risk factors

Lichen nitidus is more likely to develop in children and young adults.

Complications

Lichen nitidus is a harmless condition that doesn't result in long-term skin problems or medical complications. However, the appearance may cause a person to be self-conscious or embarrassed about his or her appearance.

Preparing for your appointment

You'll likely start by seeing your child's pediatrician or your primary care doctor if your child or you are experiencing a skin condition. You may be referred, however, to a specialist in skin disorders (dermatologist).

Your doctor or dermatologist will likely ask you a number of questions regarding the symptoms. Be prepared to answer the following:

• When did you first notice the appearance of the tiny bumps?
• Where are the patches of bumps located?
• Have the patches of bumps changed in appearance over time?
• Do the bumps itch? How much or how often?
• Does anything further irritate the site, such as certain soaps or lotions?
• Do you or does your child have any known allergies?

It's also a good idea to bring along a list that includes:

• Prescription medications you or your child takes
• Over-the-counter drugs or dietary supplements you or your child takes regularly

Tests and diagnosis

Your doctor or dermatologist makes a diagnosis of lichen nitidus or another skin condition based on the information you provide about the symptoms and a careful examination of the skin abnormality.

Your doctor may use a hand-held magnifying glass to look at your skin. Or he or she may take a small sample of tissue (biopsy) and examine it under a microscope.

Treatments and drugs

For most people, lichen nitidus lasts for a few months to a year. The condition usually clears up on its own without treatment. After it clears up, the appearance of the skin is usually normal with no scarring or permanent change to skin color.

If lichen nitidus causes itching or if you have concerns about your appearance or your child's appearance, your doctor may prescribe one of the following treatments:

• Corticosteroids may reduce inflammation associated with lichen nitidus. The side effects vary depending on whether it's used as an ointment applied directly to the skin (topical) or taken as a pill (oral). Long-term use of topical corticosteroids can cause thinning of the skin, a lessening of the treatment effect and other skin problems. Long-term use of oral corticosteroids can cause weakening of the bones (osteoporosis), diabetes, high blood pressure and high cholesterol.

• Retinoid is a synthetic version of vitamin A that can be a topical or oral treatment. The topical treatment doesn't cause the side effects associated with corticosteroids, but it may irritate the skin.

  Because both topical and oral retinoid can cause birth defects, it shouldn't be used by women who are pregnant or planning to become pregnant in the near future. Your doctor can advise you on necessary precautions.

• Antihistamines act against a protein called histamine that is involved in inflammatory activity. An oral or topical antihistamine may relieve itching associated with lichen nitidus.

• Phototherapy, a type of light therapy, may help clear up lichen nitidus. It uses ultraviolet A (UVA) light, which penetrates deep into the skin. This therapy is usually used in combination with oral or topical psoralen, a drug that makes the skin more sensitive to UVA light.

  Short-term side effects of this therapy may include nausea, headache and itching. To avoid sunburns, you must be careful to avoid sun exposure for a couple of days after taking psoralen. Also, you must wear special UVA-absorbing sunglasses for a couple of days to protect your eyes.