Published on 19/03/2015 by admin
Filed under Dermatology
Last modified 19/03/2015
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Andrew L. Wright
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 1–2 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.
Lichen nitidus persists for long periods of time, 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 UVA (PUVA) and 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.
Biopsy
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.
Park JH, Choi YL, Kim WS, Lee DY, Yang JM, Lee ES, 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.
Kim YC, Shim SD. Int J Dermatol 2006; 45: 615–17.
Treatment of Skin Disease Comprehensive Therapeutic Strategies 4e
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Topical corticosteroids
UVB
