A Case of the Lichen Nitidus with Atypical Presentation

Abstract

Lichen nitidus is a rare, chronic, papulosquamous disease that is characterized by minute, flesh-colored, shiny, multiple, dome-shaped papules. Variants of lichen nitidus are purpuric, keratodermic, vesicular and hemorrhagic, petechial, perforating, spinous follicular, linear and actinic types. The pathogenesis of lichen nitidus are unknown. The histopathologic findings in lichen nitidus are very characteristic and shown hyperplastic rete ridges in a 'ball and claw' configuration. Treatment especially is counseled in the presence of pruritus and for the cosmetic reasons. 15-year-old male patient applied to hospital with the complaints of lesions for 4 months and healing as brown coloring. It is diagnosed as lichen nitidus clinically and histopathologically. His lesions were localized atypically and healed leaving postinflammatory hyperpigmentation. As a treatment, topical corticosteroid pomade and oral antihistaminic tablet were began. Lesions gave good response to the treatment. We reported this case due to its rarity.

Keywords

• Lichen nitidus, papuloskuamous diseases, postinflammatory hyperpigmentation

Atipik Görünümlü Liken Nitidus Olgusu

Abstract

Liken nitidus nadir görülen, kronik, papuloskuamöz bir hastalık olup küçük, deri renginde, çok sayıda, düğme şeklinde papüllerle karakterizedir. Liken nitidusun varyantları; purpurik, keratodermik, veziküler ve hemorajik, peteşial, perforan, spinöz foliküler, lineer ve aktinik tiplerdir. Liken nitidusun patogenezi bilinmemektedir. Histopatolojik bulguları oldukça tipik olup hiperplastik rete uçları pençe ve top benzeri görünüm göstermektedir. Tedavi kaşıntı varlığında ve kozmetik amaçla gerekmektedir. Genellikle sekelsiz veya hipopigmente maküller ile iyileşmektedir. Onbeş yaşında erkek hasta gövdesinde 4 aydır başlayan ve kahverengi leke bırakarak iyileşen lezyonlar nedeniyle başvurdu. Klinik ve histopatolojik olarak liken nitidus tanısı kondu. Olgumuzun lezyonları atipik yerleşim göstermekteydi ve postinflamatuvar hiperpigmentasyonla iyileşmekteydi. Tedavide topikal kortikosteroid pomad ve oral antihistaminik tablet başlandı. Tedaviye iyi cevap verdi. Olgumuz nadir görülmesi nedeniyle bildirilmektedir.

Keywords

• Liken nitidus, papuloskuamöz hastalık, postinflamatuvar hiperpigmentasyon

References

1. Arizaga AT, Gaughan MD, Bang RH. Generalized lichen nitidus. Clin Exp Dermatol 2002;27:115-7.
2. Soroush V, Gurevitch AW, Peng SK. Generalized lichen nitidus: Case report and literature review. Cutis 1999;64:135-6.
3. Al-Mutairi N, Hassanein A, Nour-Eldin O, Arun J. Generalized lichen nitidus. Ped Dermatol 2005;22:158-60.
4. Shiohara T, Kano Y. Lichen planus and lichenoid dermatoses. In: Bolognia JL, Lorizzo JL, Rapini R, eds. Dermatology, 2th ed. London: Mosby, 2008;159-80.
5. Kim YC, Shim SD. Two cases of generalized lichen nitidus treated successfully with narrow-band UV-B phototherapy. Int J Dermatol 2006;45:615-7.
6. Pielop JA, Hsu S. Tiny, skin-colored papules on the arms and hands. Am Fam Physician 2005;71:343-4.
7. Rallis E, Verros C, Moussatou V,et al. Generalized purpuric lichen nitidus. Report of a case and review of the literature. Derm Online J 2007;13(2):5
8. MacDonald AJ, Drummond A, Chui D, Holmes S. Lichen nitidus and lichen spinulosus or spinous follicular lichen nitidus? (letter). Clin Exp Dermatol 2005;30:452-3.

9. Chen W, Schramm M, Zouboulis CC. Generalized lichen nitidus. J Am Acad Dermatol 1997;36:630-1.
10. Kubota Y, Kıryu H, Nakayama J. Generalized lichen nitidus succesfully treated with an antituberculous agent. Br J Dermatol 2002;146:1081-3.