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Lichen nitidus in Adult
See also in: Anogenital
Other Resources UpToDate PubMed

Lichen nitidus in Adult

See also in: Anogenital
Contributors: Vivian Wong MD, PhD, Gil Weintraub MD, Belinda Tan MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Lichen nitidus is a benign, chronic, cutaneous eruption characterized by the presence of small, discrete, uniform, often skin-colored papules that present in clusters or linear arrays. It most commonly affects children and young adults, although it can be found in patients of all ages.

Lichen nitidus may be generalized or focal, but it is commonly found on the chest, abdomen, flexor surfaces of the upper extremities, dorsal hands, and anogenital region (including the shaft and glans of the penis). Lichen nitidus actinicus is a variant of lichen nitidus that has been reported more frequently in Black individuals as well as individuals from the Middle East and Indian subcontinent. Patients may complain of pruritus over affected areas, although these micropapules are typically asymptomatic.

While the etiology of lichen nitidus remains unclear, it is important to note that it is typically not associated with laboratory abnormalities. Medication-related cases (following administration of nivolumab, tremelimumab, mogamulizumab, and interferon alpha) and familial forms have been reported.

Lichen nitidus is chronic and persistent, but the majority of patients ultimately clear spontaneously over the course of several months without residual atrophy or pigmentary changes.

Codes

ICD10CM:
L44.1 – Lichen nitidus

SNOMEDCT:
41890004 – Lichen nitidus

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Atopic dermatitis
  • Flat wart
  • Follicular eczema (see Atopic dermatitis)
  • Recurrent and disseminate Infundibulofolliculitis
  • Keratosis pilaris
  • Lichen planus
  • Lichen spinulosus
  • Lichen scrofulosorum (see Cutaneous tuberculosis)
On genital skin, also consider:
  • Molluscum contagiosum
  • Pearly penile papules
  • Bowenoid papulosis
  • Genital wart
  • Fordyce spots

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:12/10/2018
Last Updated:01/05/2022
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Patient Information for Lichen nitidus in Adult
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Contributors: Sokhna Seck, Hope Mitchell MD
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Lichen nitidus in Adult
See also in: Anogenital
A medical illustration showing key findings of Lichen nitidus : Abdomen, Chest, Tiny papules, Clustered configuration, Upper extremities
Clinical image of Lichen nitidus - imageId=1237603. Click to open in gallery.  caption: 'Multiple small, monomorphic, whitish papules on the abdomen and forearm. Note the linear array (Koebner phenomenon) on the forearm.'
Multiple small, monomorphic, whitish papules on the abdomen and forearm. Note the linear array (Koebner phenomenon) on the forearm.
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