A Case of Palmar Lichen Nitidus Presenting as a Clinical Feature of Pompholyx

Abstract

Lichen nitidus (LN) is an uncommon chronic eruption of an unknown cause, and it is characterized by tiny, discrete, flesh-colored papules. The sites of predilection are the genitalia, trunk and extremities. Unilateral palmar involvement with pruritus is infrequent. We report here on a case of LN confined to the right palm, and the patient presented with multiple, pruritic, erythematous to flesh-colored, tiny papules and vesicles that mimicked pompholyx. The histopathological examination of a skin biopsy specimen showed the typical findings of LN. (Ann Dermatol 22(2) 235

Isolated palmar lichen nitidus- A diagnostic challenge: First Case from Eastern India

“…Most of the previously reported cases of palmar LN have shown the mean age of onset around the fifth decade (age range 37~52);[ 2 ] however, our patient presented with palmer LN in the first decade (age seven-and-half years). LN is usually asymptomatic; however, it can also be pruritic at times.…”

“…[ 4 5 ] Also, palmar LN is frequently associated with plantar lesions. [ 2 ] However, in our case, only isolated palmar involvement was seen thus adding to the diagnostic confusion. There are very few reports of isolated palmer LN,[ 4 6 7 ] and our case appears to be one of them; the first one from Eastern India.…”

“…Lichen nitidus (LN) is a relatively uncommon chronic inflammatory disease, characterized by minute (1-2 mm), shiny, flat-topped, exquisitely discreet, pale to skin-colored papules, most commonly distributed over the penis, lower abdomen, inner surface of the thighs, dorsal hands/forearms, buttocks etc. [ 1 ] Rarely, they may present on the palms, soles, nail and mucosa,[ 2 ] where this characteristic morphology is missing, thus posing a diagnostic problem. However, typical LN lesions are usually present elsewhere to aid in the diagnosis.…”

“…Because LN is asymptomatic, treatment is usually not necessary; however, topical high or super potent corticosteroid, topical calcineurin inhibitors, NBUVB, PUVA[ 1 ] or oral astemizole[ 2 ] have been found to be effective. Palmar LN, showing a chronic course, is usually refractory to these conventional treatments.…”

Pink papules on the dorsum of the finger

“…Rarely, the lesions can persist indefinitely. 1,3,4,8 The absence of symptoms in conjunction with a benign natural history renders treatment unnecessary in most cases. However, topical mid-to high-potency corticosteroids may accelerate resolution of the lesions, as well as topical tacrolimus and dinitrochlorobenzene.…”