Generalized lichen nitidus.
Lichen nitidus is a rare chronic condition of unknown etiology. Generalized lichen nitidus is even rarer. We report here a 5-year-old girl who had multiple, asymptomatic, discrete, 1 to 2 mm flesh-colored, shiny, flat, papules on her face, upper limbs, and thighs with relative sparing of the trunk. Resolution of these papular lesions was followed by hyperpigmented macules in those areas. Histopathologic examination of a papular lesion revealed a localized granulomatous lymphohistiocytic infiltrate in an expanded dermal papilla with thinning of overlying epidermis and downward extension of the rete ridges at the lateral margin of the infiltrate, producing a typical "claw clutching a ball" picture, confirming our clinical diagnosis of lichen nitidus. The pigmented macules showed melanin pigmentation on histology. There was no response to oral astemizole treatment for 3 months. However, the lichen nitidus lesions resolved spontaneously without any further treatment over the next year, leaving behind a prominent pigmentary disturbance.
Al-Mutairi
Nawaf
N
Department of Dermatology, Farwaniya Hospital, Kuwait. nalmut@usa.net
Hassanein
Ayman
A
Nour-Eldin
Osama
O
Arun
Joshi
J
D016589:Astemizole / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D017513:Lichen Nitidus / Q000175:diagnosis* / Q000188:drug therapy; D012867:Skin / Q000187:drug effects / Q000473:pathology*; D016896:Treatment Outcome
D006634:Histamine H1 Antagonists; D016589:Astemizole