Clinico epidemiological study of lichen nitidus in a tertiary care centre in South India

Abstract

INTRODUCTIONLichen nitidus is an uncommon chronic cutaneous eruption that exhibits distinct morphology and histopathological features. It was first described by Felix pinks in 1901. The exact etiology is not known.1 An unknown antigenic stimulus induced cell mediated immune response, resulting in superficial dermal granulomatous infiltrate, is responsible for the characteristic cutaneous eruption seen in lichen nitidus. The factors implicated in its etiology include tuberculosis, Hepatitis B vaccination, UV radiation in actinic type, and genetic factors in familial lichen nitidus. It was also considered as a variant of lichen planus. It is a self-limiting condition that most commonly affects young adults and children.2 It is clinically characterized by asymptomatic, discrete, flat or dome shaped, flesh colored papules with a shiny surface. It is distributed most frequently in the flexor surface of extremities, trunk and genitalia. Rare sites of involvement of include the face, oral mucosa and palms and soles.3 Koebner phenomenon is a characteristic finding seen in lichen nitidus and it occurs 1-2 weeks following minor trauma. Clinical variants like actinic, generalized, hemorrhagic or ABSTRACT Background: Lichen nitidus is an uncommon chronic cutaneous eruption that exhibits a distinct morphology and histopathological features. Hepatitis B vaccination, UV radiation in actinic type, and genetic factors in familial lichen nitidus. It was also considered as a variant of lichen planus. The aim of the study was to assess the clinico epidemiological features of lichen nitidus and its clinical associations. Methods: A total of 30 patients presented with the features of lichen nitidus were selected for the study. The analysis of cases was done by recording a detailed history and a thorough clinical examination. History regarding the etiological factors like tuberculosis, drug intake, photosensitivity, recent vaccination and family history were noted. Results: In this study most of the patients were asymptomatic (70%). Only 30% were symptomatic among which 23% presented with mild itching and only 7% with moderate to severe itching. In our study, the most frequent sites of involvement observed were the upper limb in 25 cases (83%), followed by trunk in 17 cases (57%), lower limb in 15 cases (50%) and only 2 patients (7%) with facial involvement.Conclusions: The present study shows that lichen nitidus is common in young adults and children with the male predominance. Most of the cases were asymptomatic. Although no definite etiological factors could be made out in most cases, few patients showed the risk factors like photosensitivity and family history.

Dermoscopy of lichen nitidus: a study of 20 cases

“…Clinically, 55% patients were asymptomatic while 45% complained of itching, consistent with the previous studies and the asymptomatic nature of illness in general. 3 Forearms, arms, dorsal aspect of hands and back were the most common sites in decreasing order of frequency.…”