The lichen nitidus was considered in its first description at the beginning of the 20th century as an infectious granuloma . Since 1927 the law of similarity and sometimes coexistence of lichen nitidus and lichen planus ( up to 8 % of tie , which is an of import figure ) were found . Since then , and to this day , the infective interval , if any , of these two entities , has not yet been well established .
Lichen nitidus is a rare inflammatorydermatitisof unknown etiology and characterized by the appearance of multiple tiny , whitish papule with a shiny surface , usually asymptomatic .
Is Lichen Nitidus Contagious?
Lichen nitidus is not a contagious disease . It is a ego - determine disease that can not be spread or transmitted to other people . It is a benign and inveterate seditious peel status that is usually harmless and resolve without treatment and leaves the hide without long - term effect .
There is some grounds to support the idea that lichen nitidus is a random variable of lichen planus . First , there are well - documented cases of patients in whom lichen planus lesions coexist with lichen nitidus wound . In addition , the initial lesions of lichen planus can be indistinguishable , both clinically and histopathologically , from those of lichen nitidus .
In any case , most investigator consider these two physical process as two different entities and with enough clinical and histopathological personality to well install a differential diagnosing between both processes . In any sheath , as in lichen planus , the cause of lichen nitidus rest unknown .
The typical lesion of lichen nitidus consist of tiny papules , the size of it of a pinhead , with hemispheric word structure and a flat , shiny surface . Usually , the colouring of these papule is whitish and is usually asymptomatic .
Most lesions remain as isolated papules , although they be given to flock in a certain anatomical region . They can settle in any arena of the body control surface , anterior pectus and abdomen and the gluteal area are the most frequently affected area . Sometimes it is a generalised skin rash . The majority of cases occur in children or young adult and cases of category relative incidence have been reported . When the palms or fillet of sole are sham , the lesions show a different morphology and resemble dyshidrotic eczema or purpuric lesion . In these cases , only the presence of typical lichen nitidus lesions in other organic structure area and the histopathological study of the palmoplantar lesions let establishing the correct diagnosis .
Rare forms of lichen nitidus include lesions of linear statistical distribution or the growing of lesions on previous scar as an expression of an isomorphous phenomenon .
The coexistence of lesions of lichen planus and lichen nitidus in the same patient role is not rarified , which put up the opinion that these are two morphologic expression of the same process . It also affirm the human relationship between these two processes , the fact that often patients with lichen nitidus show nail abnormality , in the form of longitudinal grooves . However , mucous tissue layer involvement in patients with lichen nitidus is much rarer than in lichen planus .
The evolution of the lesion is varying , with cases of spontaneous exponentiation in a few months and others of perseverance for years , in bitchiness of even a treatment with topical corticosteroid .
The diagnosing is affirm by a skin biopsy . The histopathology of lichen nitidus lesion is characteristic ; the papule is constituted by a dense inflammatory infiltrate located in an hypertrophied cutaneous papilla and immediately below the epidermic epithelial tissue . This inflammatory infiltrate is mainly constituted by lymphocytes , histiocyte and it is not rare to observe some gargantuan Langhans type multinucleated cellular phone . Sometimes , there are also plasma cell as one of the portion of the incitive infiltrate . The epidermis that covers this infiltrate is flattened and vacuolization is sometimes observed in its basal row .
Usually , no treatment is necessary , since the lesion of lichen nitidus are asymptomatic ( do not give rise symptom ) and self - set ( they disappear in a sure menses of clip ) . In case of very wide or very symptomatic lesions , estimable result have been obtain with topical adrenal cortical steroid or antihistamines .
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