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Lichen nitidus
Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports
Lichen nitidus is an uncommon, idiopathic condition presenting with 1- to 2-mm diameter flat-topped or domed papules. They usually remain discrete but may be grouped. They can occur on any part of the body but mainly affect the forearms, penis, abdomen, chest, and buttocks. Palmar lesions may be hemorrhagic.
Management Strategy
Lichen nitidus persists for long periods but is generally asymptomatic, and treatment may not be necessary . No large controlled clinical trials have been reported; most treatments are based on anecdotal reports.
In patients with localized disease, potent topical corticosteroids and topical tacrolimus can be successful in clearing lesions. For more extensive disease, phototherapy (psoralen plus ultraviolet A [PUVA] and ultraviolet B [UVB]) has been reported to be successful. Antihistamines, including astemizole and cetirizine, are reported to have cleared lesions. Generalized lesions have cleared with PUVA, UVB, and acitretin .
Successful treatment of lichen nitidus
Wright S. Arch Dermatol 1984; 120: 155–6.
A 24-year-old woman with a 12-year history of extensive lesions cleared with 1 month’s treatment using 0.05% fluocinonide cream twice daily. No recurrence was noted at 12-month follow-up.
Treatment of generalized lichen nitidus with narrow band ultraviolet light
Park JH, Choi YL, Kim WS, et al. J Am Acad Dermatol 2006; 54: 545–6.
A 33-year-old man with a 3-year history of generalized disease was reported as almost clear after 28 treatments and remained clear 11 months after cessation of therapy. A 10-year-old with generalized disease was reported as completely clear after 41 treatments and was clear at the 6-month follow-up.
Two cases of generalized lichen nitidus treated successfully with narrow band UVB phototherapy
Kim YC, Shim SD. Int J Dermatol 2006; 45: 615–7.
A 7-year-old girl and a 10-year-old boy, both with generalized lichen nitidus, were treated with narrowband UVB phototherapy, receiving between 17 and 30 treatments with maximum 9.5 J/cm 2 . Both were reported as almost clear at the end of treatment and remained clear for at least 11 months.
A case of generalized lichen nitidus successfully treated with narrow-band ultraviolet B treatment
Bilgili SG, Karadag AS, Calka O, et al. Photodermatol Photoimmunol Photomed 2013; 29: 215–7.
A 15-year-old girl with generalized lichen nitidus was treated with 25 sessions of UVB over a 2-month period with complete clearance.
A case of generalized lichen nitidus successfully treatment with natural daylight therapy
Berman H, Truong A, Cheng C. Paediatr Dermatol 2019; 36: 690–2.
A 6-year-old boy with generalized lichen nitidus had complete resolution after 3 months of daily exposure in peak sun for 30 minutes in combination with once-daily application of topical tacrolimus 0.03% to the face and fluticasone acetate 0.01% to the body.
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