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Generalized lichen nitidus.

Nawaf Al-Mutairi1, Ayman Hassanein, Osama Nour-Eldin

  • 1Department of Dermatology, Farwaniya Hospital, Kuwait. nalmut@usa.net

Pediatric Dermatology
|April 5, 2005
PubMed
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Generalized lichen nitidus, a rare skin condition, presents as small, flesh-colored papules that resolve spontaneously, leaving hyperpigmented macules. This case highlights the condition's typical presentation and spontaneous resolution in a pediatric patient.

Area of Science:

  • Dermatology
  • Pediatric Dermatology
  • Histopathology

Background:

  • Lichen nitidus is a rare, chronic skin condition with an unknown cause.
  • Generalized lichen nitidus is an exceptionally rare variant, making documented cases valuable for understanding its presentation and progression.

Observation:

  • A 5-year-old girl presented with asymptomatic, discrete, 1-2 mm flesh-colored papules on her face, upper limbs, and thighs.
  • The papules were shiny, flat, and resolved spontaneously over a year, transitioning into hyperpigmented macules.
  • Histopathology confirmed lichen nitidus with a characteristic 'claw clutching a ball' appearance in the dermal papilla.

Findings:

  • The histopathologic findings were consistent with lichen nitidus, showing a granulomatous infiltrate.
  • The lesions resolved spontaneously without response to oral astemizole treatment.

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  • Post-resolution, significant hyperpigmentation was observed, indicating pigmentary disturbance.

    • Implications:

    • This case contributes to the limited literature on generalized lichen nitidus in children.
    • It underscores the potential for spontaneous resolution and subsequent pigmentary changes.
    • Highlights the importance of histopathologic confirmation for accurate diagnosis and management planning.