Lichen Nitidus

What is Lichen Nitidus?

Lichen Nitidus is a somewhat rare, chronic discharge that is characterized clinically as flat-topped, asymptomatic, skin-colored micropapules that may appear as hypopigmented against dark skin. Lichen nitidus mostly affects young adults and children.

Sometimes minimal scaling is present or can be induced by rubbing the tops of the papules. The papules are about one to three millimeters in diameter and do not contain any fluid. The disease is usually non pruritic (doesn’t cause the sensation of needing to scratch) and painless although long-term itching may occur in some cases.

Some dermatologists refer to this condition as “mini lichen planus”. The lesions can be localized on the legs, chest, back, hands, or abdomen and the exact cause of the condition is unknown. The condition can be easily diagnosed by an experienced doctor but a biopsy can be performed to confirm the diagnosis.

What are the Symptoms of Lichen Nitidus?

Main signs of Lichen Nitidus include:

  • Shiny skin bumps flesh-colored skin bumps
  • Itching
  • Flat-topped skin bumps

Symptoms may increase during the summer, when it’s humid, and in situations of stress.

Lichen Nitidus Causes

There is no known cause for lichen nitidus. It typically starts in childhood, especially in preschool, middle school, or young adulthood. All races and both sexes are affected equally by lichen nitidus. Research also suggests there have been hereditary causes.

Lichen nitidus occasionally occurs in connection with:

  • Lichen planus
  • Juvenile chronic arthritis
  • Down syndrome
  • Crohn’s disease
  • Atopic dermatitis
  • HIV infection
  • Congenital megacolon

T lymphocytes cause papules to appear due to inflammation caused by white blood cells. These particular cells are usually working to heal injuries or diseases, including small exterior cuts. It is unknown as to what causes lichen nitidus to activate T lymphocytes.

How is Lichen Nitidus Treated?

Generally, lichen nitidus is asymptomatic and requires no treatment.

In cases of severe itching or unsightly appearance, treatment may involve moisturizers and local cortisone. Other treatments may include oral steroids and PUVA, UVA/UVB phototherapy, astemizole, acitretin, and etretinate.

Lichen Nitidus Prevention

The condition typically arrives unexpectedly and also leaves unannounced, often without necessary treatment. It is difficult to prevent lichen nitidus as the cause is unknown, but the symptoms can typically be prevented.

Long-term side effects of the diagnosis can be prevented with a variety of treatments. Corticosteroids can aid in lowering inflammation and are available in topical or oral form. Retinoid is also a topical or oral treatment, but one of the side effects is that it can irritate skin. Retinoid should be avoided for those who are pregnant due to its tendency to cause birth defects.

Additional topical medications that can prevent symptoms of lichen nitidus are Protopic (tacrolimus), which can aid in subduing the immune response. Tanning beds should be avoided while taking Protopic (tacrolimus). Antihistamines are incredibly helpful in preventing inflammatory activity typically associated with lichen nitidus. Light therapy can prevent symptoms of lichen nitidus due to the properties UVA light has for permeation into the skin. UVA therapy is typically combined with a drug that increases sensitivity to UVA light. Sun exposure should be avoided because lichen nitidus symptoms are best prevented with the combination of medication and UVA therapy. Appropriate UVA skin care for phototherapy is necessary to successfully prevent long-term effects of lichen nitidus.

Last Reviewed:
October 09, 2016
Last Updated:
March 12, 2018