Background

Lichen nitidus is a relatively rare, chronic skin eruption that is characterized clinically by asymptomatic, flat-topped, skin-colored micropapules (see the image below).^[1]It mainly affects children and young adults.^[2] Several clinical variants of lichen nitidus have been reported, and a number of disorders have been associated with it (see Presentation). Optimal therapy remains to be established.

Multiple skin-colored shiny papules associated with lichen nitidus.

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Next: Pathophysiology

Pathophysiology

The skin is the primary organ system affected. Mucous membranes and nails^[3]also might be involved. Lichen planus can clinically mimic lichen nitidus and can sometimes coexist with lichen nitidus.

Next: Pathophysiology

Etiology

The etiology of lichen nitidus is unknown. Immune responses and genetic factors have been suggested as possible contributors.^[4]Controversy exists regarding the relationship between lichen planus and lichen nitidus.^[5]

Next: Pathophysiology

Epidemiology

The frequency of lichen nitidus has not been defined, because of its uncommon occurrence. In a study from Togo that included 959 cases of lichenoid dermatosis in the period from January 1997 to December 2016, lichen nitidus accounted for only 23 of the 959 (2.4%).^[6]

Lichen nitidus may affect any age group, but it most commonly develops in childhood or early adulthood. No sex predilection exists. However, generalized variants appear to occur predominantly in females. No racial predilection is reported.

Next: Pathophysiology

Prognosis

Lichen nitidus is a benign disease with no associated mortality or complications. Although the disease may remain active for several years, spontaneous resolution is usual.

Clinical Presentation

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Ho JD, Al-Haseni A, Rosenbaum MT, Goldberg LJ. Hyperkeratotic and hypertrophic lichen nitidus. Dermatol Online J. 2017 Oct 15. 23 (10):[QxMD MEDLINE Link]. [Full Text].
Bettoli V, De Padova MP, Corazza M, Virgili A. Generalized lichen nitidus with oral and nail involvement in a child. Dermatology. 1997. 194 (4):367-9. [QxMD MEDLINE Link].
Stolze I, Hamm H. [Lichen nitidus and lichen striatus]. Hautarzt. 2018 Feb. 69 (2):121-126. [QxMD MEDLINE Link].
Cho EB, Kim HY, Park EJ, Kwon IH, Kim KH, Kim KJ. Three cases of lichen nitidus associated with various cutaneous diseases. Ann Dermatol. 2014 Aug. 26 (4):505-9. [QxMD MEDLINE Link]. [Full Text].
Teclessou JN, Akakpo AS, Saka B, Mouhari-Toure A, Kombate K, Pitche P. Lichenoid dermatoses in hospitals in Lomé, Togo: 959 cases. Med Sante Trop. 2018 Aug 1. 28 (3):261-264. [QxMD MEDLINE Link].
Gupta SK, Dhiman A, Shukla R. A Case of Familial Lichen Nitidus with Atypical Morphology. Indian J Dermatol. 2022 Nov-Dec. 67 (6):769-772. [QxMD MEDLINE Link]. [Full Text].
Al-Mutairi N, Hassanein A, Nour-Eldin O, Arun J. Generalized lichen nitidus. Pediatr Dermatol. 2005 Mar-Apr. 22 (2):158-60. [QxMD MEDLINE Link].
Glorioso S, Jackson SC, Kopel AJ, Lewis V, Nicotri T Jr. Actinic lichen nitidus in 3 African American patients. J Am Acad Dermatol. 2006 Feb. 54 (2 Suppl):S48-9. [QxMD MEDLINE Link].
Yoon TY, Kim JW, Kim MK. Two cases of perforating lichen nitidus. J Dermatol. 2006 Apr. 33 (4):278-80. [QxMD MEDLINE Link].
Munro CS, Cox NH, Marks JM, Natarajan S. Lichen nitidus presenting as palmoplantar hyperkeratosis and nail dystrophy. Clin Exp Dermatol. 1993 Jul. 18 (4):381-3. [QxMD MEDLINE Link].
Jetton RL, Eby CS, Freeman RG. Vesicular and hemorrhagic lichen nitidus. Arch Dermatol. 1972 Mar. 105 (3):430-1. [QxMD MEDLINE Link].
Yáñez S, Val-Bernal JF. Purpuric generalized lichen nitidus: an unusual eruption simulating pigmented purpuric dermatosis. Dermatology. 2004. 208 (2):167-70. [QxMD MEDLINE Link].
Lestringant GG, Piletta P, Feldmann R, Galadari I, Frossard PM, Saurat JH. Coexistence of atopic dermatitis and lichen nitidus in three patients. Dermatology. 1996. 192 (2):171-3. [QxMD MEDLINE Link].
Kawakami T, Soma Y. Generalized lichen nitidus appearing subsequent to lichen planus. J Dermatol. 1995 Jun. 22 (6):434-7. [QxMD MEDLINE Link].
Scheinfeld NS, Lehman D. Condyloma with lichen nitidus. Skinmed. 2005 May-Jun. 4 (3):177-8. [QxMD MEDLINE Link].
Taniguchi S, Chanoki M, Hamada T. Recurrent generalized lichen nitidus associated with amenorrhea. Acta Derm Venereol. 1994 May. 74 (3):224-5. [QxMD MEDLINE Link].
Kano Y, Shiohara T, Yagita A, Nagashima M. Erythema nodosum, lichen planus and lichen nitidus in Crohn's disease: report of a case and analysis of T cell receptor V gene expression in the cutaneous and intestinal lesions. Dermatology. 1995. 190 (1):59-63. [QxMD MEDLINE Link].
Scheinfeld NS, Teplitz E, McClain SA. Crohn's disease and lichen nitidus: a case report and comparison of common histopathologic features. Inflamm Bowel Dis. 2001 Nov. 7 (4):314-8. [QxMD MEDLINE Link].
Bercedo A, Cabero MJ, García-Consuegra J, Hernado M, Yaez S, Fernández-Llaca H. Generalized lichen nitidus and juvenile chronic arthritis: an undescribed association. Pediatr Dermatol. 1999 Sep-Oct. 16 (5):406-7. [QxMD MEDLINE Link].
Lam M, Lu JD, Elhadad L, Sibbald C, Alhusayen R. Common Dermatologic Disorders in Down Syndrome: Systematic Review. JMIR Dermatol. 2022 Feb 8. 5 (1):e33391. [QxMD MEDLINE Link]. [Full Text].
Henry M, Metry DW. Generalized lichen nitidus, with perioral and perinasal accentuation, in association with Down syndrome. Pediatr Dermatol. 2009 Jan-Feb. 26 (1):109-11. [QxMD MEDLINE Link].
Botelho LF, Magalhães JP, Ogawa MM, Enokihara MM, Cestari Sda C. Generalized Lichen nitidus associated with Down's syndrome: case report. An Bras Dermatol. 2012 May-Jun. 87 (3):466-8. [QxMD MEDLINE Link].
Kansal NK, Vasisht S, Bhatia R. Dermoscopic features of lichen nitidus. BMJ Case Rep. 2024 Apr 11. 17 (4):[QxMD MEDLINE Link]. [Full Text].
Ochała-Gierek G, Bergler-Czop B, Gierek M. A case report of lichen nitidus and its dermoscopic features. Postepy Dermatol Alergol. 2023 Feb. 40 (1):173-175. [QxMD MEDLINE Link]. [Full Text].
Dai H, Jiang HY, Xu AE. In vivo reflectance confocal microscopy for evaluating seborrheic keratosis, verruca plana, syringoma and lichen nitidus. Skin Res Technol. 2021 Mar. 27 (2):272-276. [QxMD MEDLINE Link].
Dobbs CR, Murphy SJ. Lichen nitidus treated with topical tacrolimus. J Drugs Dermatol. 2004 Nov-Dec. 3 (6):683-4. [QxMD MEDLINE Link].
Park J, Kim JI, Kim DW, Hwang SR, Roh SG, Kim HU, et al. Persistent generalized lichen nitidus successfully treated with 0.03% tacrolimus ointment. Eur J Dermatol. 2013 Nov-Dec. 23 (6):918-9. [QxMD MEDLINE Link].
Teichman JMH, Mannas M, Elston DM. Noninfectious Penile Lesions. Am Fam Physician. 2018 Jan 15. 97 (2):102-110. [QxMD MEDLINE Link]. [Full Text].
Sehgal VN, Jain S, Kumar S, Bhattacharya SN, Singh N. Generalized lichen nitidus in a child's response to cetirizine dihydrochloride/levamisol. Australas J Dermatol. 1998 Feb. 39 (1):60. [QxMD MEDLINE Link].
Lucker GP, Koopman RJ, Steijlen PM, van der Valk PG. Treatment of palmoplantar lichen nitidus with acitretin. Br J Dermatol. 1994 Jun. 130 (6):791-3. [QxMD MEDLINE Link].
Libow LF, Coots NV. Treatment of lichen planus and lichen nitidus with itraconazole: reports of six cases. Cutis. 1998 Nov. 62 (5):247-8. [QxMD MEDLINE Link].
Kano Y, Otake Y, Shiohara T. Improvement of lichen nitidus after topical dinitrochlorobenzene application. J Am Acad Dermatol. 1998 Aug. 39 (2 Pt 2):305-8. [QxMD MEDLINE Link].
Randle HW, Sander HM. Treatment of generalized lichen nitidus with PUVA. Int J Dermatol. 1986 Jun. 25 (5):330-1. [QxMD MEDLINE Link].
Do MO, Kim MJ, Kim SH, Myung KB, Choi YW. Generalized lichen nitidus successfully treated with narrow-band UVB phototherapy: two cases report. J Korean Med Sci. 2007 Feb. 22 (1):163-6. [QxMD MEDLINE Link].
Kim YC, Shim SD. Two cases of generalized lichen nitidus treated successfully with narrow-band UV-B phototherapy. Int J Dermatol. 2006 May. 45 (5):615-7. [QxMD MEDLINE Link].
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Media Gallery

Multiple skin-colored shiny papules associated with lichen nitidus.
Multiple shiny lichens over the penis.
Köbner phenomenon in lichen nitidus.
Lichen nitidus.

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#author-disclosures{display:block}#author-disclosures.modal-layer{position:relative}#author-disclosures .modal-content{max-height:none}#author-disclosures .close-modal{display:none}

Author

Zeina Tannous, MD Associate Professor and Chair, Lebanese American University; Chief of Dermatology, University Medical Center, Rizk Hospital, Lebanon; Visiting Associate Professor in Dermatology, Harvard Medical School; Clinical Associate in Dermatology, Massachusetts General Hospital

Zeina Tannous, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, International Society of Cosmetic and Laser Surgeons, International Academy of Cosmetic Dermatology, Lebanese Dermatological Society, Lebanese Order of Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Warren R Heymann, MD Head, Division of Dermatology, Professor, Department of Internal Medicine, Rutgers New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Emeritus Professor, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, American Contact Dermatitis Society, Association of Military Dermatologists, Association of Professors of Dermatology, American Dermatological Association, Women's Dermatologic Society, Medical Dermatology Society, Dermatology Foundation, Society for Investigative Dermatology, Washington DC Dermatological Society, Atlantic Dermatologic Society, Philadelphia Dermatological Society, Pennsylvania Academy of Dermatology, College of Physicians of Philadelphia

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

David P Fivenson, MD Associate Director, St Joseph Mercy Hospital Dermatology Program, Ann Arbor, Michigan

David P Fivenson, MD is a member of the following medical societies: American Academy of Dermatology, Michigan State Medical Society, Society for Investigative Dermatology, Photomedicine Society, Wound Healing Society, Michigan Dermatological Society, Medical Dermatology Society

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Nelly Rubeiz, MD, to the development and writing of this article.

Lichen Nitidus

Background

Pathophysiology

Etiology

Epidemiology

Prognosis

References

Tables

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