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What is Lichen Nitidus?
Lichen nitidus is a rare, chronic inflammatory skin condition that is idiopathic in cause. It is characterized by tiny, skin eruptions or papules that are somehow discrete but uniform in distribution, and are pale to reddish-brown in color. This skin condition is a benign skin disease. The skin condition is somehow mistaken for a type of skin cancer or a risk factor for skin cancer. It should be known to the public, that lichen nitidus is only a form of skin inflammation which is basically caused by some abnormal activity of our skin cells.
The condition can affect anybody, but as reported; is more common in children and young adults. The skin disease has no specific sex preference and any racial predilection.
The characteristics of the lichen nitidus is generally eruptions of skin papules or clusters of small, glistening bumps. The said papules are reported to have a linear arrangement, most commonly found on the patient’s forearms. This is identified as Koebner Phenomenon. Enumerated characteristics of lichen nitidus are the following:
- The papules are commonly linear in arrangement and are found grouped in areas such as the elbows, axilla (underarm), back of the knees and inguinal (groin) and perianal areas. These areas are technically called flexural areas.
- Some of the lesions, in the initial development, appear to be affecting the chest, abdominal area, glans penis (for men) and upper extremities (elbows). Less common or rare areas of affectation are the mucous membranes, fingernails, palms and soles of the feet.
- Size of the papules may vary. They may appear pinpoint to pinhead in size. Usually, its size is between 1 to 2 mm in diameter.
- Papules may be flat or round in shape. It is also found to be polygonal in shape.
- Color of the papules is frequently found to be the same as of the normal skin color of the patient. However, there are times when they become slightly pink because of inflammation. There is also an instance for those who have darker skin; the papules appear to be much lighter in color.
- Generally, it is asymptomatic. However, when complications arise such as further injury of the affected skin and infection follows; itchiness, fever and pus formation may develop.
Picture : Shiny papules on forearm (Skin-colored) with a foci of koebnerization
Image credit : Wikipedia
Causes Of Lichen Nitidus
Lichen nitidus has an unknown etiology. But the said skin condition is linked with the faulty process of inflammation. The white blood cells or the T lymphocytes appear to be activated when lichen nitidus develops. However, doctors and researchers have no idea what these components of the inflammatory process have to do with the skin problem, but they are found to play an influence in the skin eruptions.
As no direct cause has proven its role for lichen nitidus, a number of risk factors are linked to its development. The following diseases and disposition, according to studies, are found to be associated with lichen nitidus:
- Lichen planus. This is an inflammatory skin condition that results to red, itchy bumps on skin. White patches of the mouth mucous membranes are also manifested in this condition.
- Atopic dermatitis. This is also known as eczema. The skin condition arises with dry skin rashes usually found on the face, elbows, behind the knees, hands and feet.
- Age. Young children and those who reached young adulthood are quite at risk from lichen nitidus.
Diagnosis for Lichen Nitidus
Lichen nitidus is easily diagnosed by dermatologists through physical examination. However, it is necessary to make sure that no underlying condition is causing the skin problem. Proper visualization is done with microscopic examination of the patient’s skin. It’s also become necessary or is a given protocol to perform tissue biopsy. This can rule out the possibility of other skin conditions.
Treatment for Lichen Nitidus
Lichen nitidus can clear itself up on its own even without treatment. Usually, the skin problem lasts for a few months and sometime extends to a year. When the papules clear up, no scarring or changes in skin color are noted. However, when you are unaware of what caused or what the tiny bumps and papules are, consulting the doctor is necessary so to receive proper and ideal care. One should immediately report these accompanying signs such as fever, itching and oozing pus from the papules. These are untoward symptoms from lichen nitidus and indicate infection.
When the condition has developed the accompanying untoward symptoms, medical treatment is indicated. The following are prescribed by the doctor that can provide relief from the symptoms:
- Topical corticosteroids assist in reducing the inflammation. Ointment corticosteroids are usually prescribed but may have accompanying side effects such as thinning of skin and drug resistance. When oral corticosteroids are provided, its side effects are somehow chronic such as osteoporosis, diabetes mellitus, hypertension and cholesterolemia.
- Retinoid treatment is done in order to provide vitamin A supplement. This can be in topical or oral form which helps the skin to become healthy. One should however note that this is contraindicated to pregnant women and those who are working on it as this can cause fetal defects.
- Antihistamines help reduce inflammation. These can be in oral or topical forms which are very good in relieving discomfort from lichen nitidus itchiness.
- Phototherapy may not be necessary. But this is somehow recommended when the skin eruptions cause physical demise. This therapy helps in clearing up lichen nitidus.
- Follow-up is necessary when persistence of the skin condition is observed. One should know that the condition can remain active for years but eventually may resolves on its own or with treatment.
Is Lichen Nitidus contagious or not?
Lichen nitidus is reported as a noncontagious skin disease. Yes, many would think, at first sight and without knowledge, that lichen nitidus appears to be a highly contagious skin disease. Others identify them in areas which are not usually exposed such as the inguinal and perianal area, giving people conclusions that it can be transmitted from one person to another.
This is said to be noncontagious because no causative agent is related or associated with the disease. No infective agent is found to cause the skin disease and is most likely a self-limiting emergence of skin papules.
References:
http://emedicine.medscape.com/
http://en.wikipedia.org/wiki/
http://www.mayoclinic.com/
