Lichen nitidus in Child
Lichen nitidus may be generalized or focal, but it is commonly found on the chest, abdomen, flexor surfaces of the upper extremities, dorsal hands, and anogenital region (including the shaft and glans of the penis). Lichen nitidus actinicus is a variant of lichen nitidus that has been reported more frequently in Black individuals as well as individuals from the Middle East and Indian subcontinent. Patients may complain of pruritus over affected areas, although these micropapules are typically asymptomatic.
While the etiology of lichen nitidus remains unclear, it is important to note that it is typically not associated with laboratory abnormalities. Medication-related cases (following administration of nivolumab, tremelimumab, mogamulizumab, and interferon alpha) and familial forms have been reported.
Lichen nitidus is chronic and persistent, but the majority of patients ultimately clear spontaneously over the course of several months without residual atrophy or pigmentary changes.
L44.1 – Lichen nitidus
41890004 – Lichen nitidus
Differential Diagnosis & Pitfalls
- Atopic dermatitis
- Flat warts
- Follicular eczema (see eczema)
- Recurrent and disseminate infundibulofolliculitis
- Keratosis pilaris
- Lichen planus
- Lichen spinulosus
- Lichen scrofulosorum (see cutaneous tuberculosis)
- Papular epidermal nevus with "skyline" basal cell layer (PENS) is a rare, newly described entity where affected children develop few hyperkeratotic polygonal or rectangular papules in one or more body locations. PENS syndrome describes a subset of patients with PENS with associated neurological findings such as epilepsy or neurodevelopmental delay.