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DermAtlas: ARM - lichen nitidus
© 2001-2009, DermAtlas
Image Name: Lichen_Nitidus_1_080326   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: arm   Age: 19 years
Contributor: Monica Standish, RN    
Description: uniform grouped 2 mm papules
Comments: This 19-year-old woman developed asymptomatic uniform grouped 2 mm smooth topped papules on the left arm.

DermAtlas: Histology - lichen nitidus
© 2001-2009, DermAtlas
Image Name: lichen_nitidus_1_061101   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: abdomen   Age: 19 years
Contributor: Greg Hosler, MD, PhD    
Description: There is a nodule of inflammation within the papillary dermis. It fills the papilla forming an epidermal collarette. The epidermal change is minimal. There is no deep component. The infiltrate consists of a mixture of lymphocytes and histiocytes.
Comments: While not a classic anatomic site (usually extremities and genitals), the histology here is great for lichen nitidus. The discrete lymphohistiocytic ball in the papillary dermis with epidermal collarette yields the textbook "ball-in-claw" appearance. Lichen nitidus is an idiopathic eruption.

DermAtlas: Histology - lichen nitidus
© 2001-2009, DermAtlas
Image Name: lichen_nitidus_1_060801   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: penis   Age: 27 years
Contributor: Greg Hosler, MD, PhD    
Description: There is a nodular infiltrate largely filling 1-2 papillae in the papillary dermis. The flanking epidermis shows slight elongation of rete with a suggestion of a collarette. The infiltrate consists primarily of lymphocytes and histiocytes.
Comments: Lichen nitidus is a fairly rare, asymptomatic, idiopathic eruption. While upper extremities and trunk are typical anatomic locations, genitalia involvement of young people is not uncommon, as in this case. This is an example of the variation seen histologically in lichen nitidus. This case does not have the well-developed classic "ball-in-claw" morphology, but there is a suggestion of that here.

DermAtlas: HAND - lichen nitidus
© 2001-2009, DermAtlas
Image Name: Lichen_Nitidus_1_060721   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: hand   Age: 16 years
Contributor: Vijay Zawar, MD    
Description: symmetric uniform 1-2 mm skin colored papules
Comments: This 16-year-old boy developed asymptomatic skin colored to hypopigmented papules on the tops of his hands, feet and penile shaft which increased in number over the last 5 months. There was no history of drug exposure. Biopsy demonstrated a occasional basal cell vacoulation and dense dermal infiltrate contained within the tapered rete ridges giving a "clutch-ball" appearance. These clinical and histologic findings were typical of lichen nitidus.

DermAtlas: ELBOW - lichen nitidus
© 2001-2009, DermAtlas
Image Name: Lichen_nitidus_1_031011   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: elbow   Age: 12 years
Contributor: Shahbaz A. Janjua, MD    
Description: uniform, 2 mm, grouped, flat topped, hypopigmented papules
Comments: This 12-year-old boy developed a slowly progressive asymptomatic papular eruption on his face, trunk, extremities, and penis 3 months earlier.
Related Images: All related Images  Lichen_nitidus_5_031011  Lichen_nitidus_4_031011  Lichen_nitidus_3_031011  Lichen_nitidus_2_031011 

DermAtlas: ELBOW - lichen nitidus
© 2001-2009, DermAtlas
Image Name: Lichen_nitidus_2_031011   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: elbow   Age: 12 years
Contributor: Shahbaz A. Janjua, MD    
Description: uniform, 2 mm, grouped, flat topped, hypopigmented papules
Comments: This 12-year-old boy developed a slowly progressive asymptomatic papular eruption on his face, trunk, extremities, and penis 3 months earlier.
Related Images: All related Images  Lichen_nitidus_5_031011  Lichen_nitidus_4_031011  Lichen_nitidus_3_031011  Lichen_nitidus_1_031011 

DermAtlas: ABDOMEN - lichen nitidus
© 2001-2009, DermAtlas
Image Name: Lichen_nitidus_3_031011   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: abdomen / umbilicus (navel)   Age: 12 years
Contributor: Shahbaz A. Janjua, MD    
Description: uniform, 2 mm, grouped, flat topped, hypopigmented papules
Comments: This 12-year-old boy developed a slowly progressive asymptomatic papular eruption on his face, trunk, extremities, and penis 3 months earlier.
Related Images: All related Images  Lichen_nitidus_5_031011  Lichen_nitidus_4_031011  Lichen_nitidus_2_031011  Lichen_nitidus_1_031011 

DermAtlas: GENITAL - lichen nitidus
© 2001-2009, DermAtlas
Image Name: Lichen_nitidus_4_031011   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: genital / penis   Age: 12 years
Contributor: Shahbaz A. Janjua, MD    
Description: uniform, 2 mm, grouped, flat topped, hypopigmented papules
Comments: This 12-year-old boy developed a slowly progressive asymptomatic papular eruption on his face, trunk, extremities, and penis 3 months earlier.
Related Images: All related Images  Lichen_nitidus_5_031011  Lichen_nitidus_3_031011  Lichen_nitidus_2_031011  Lichen_nitidus_1_031011 

DermAtlas: GENITAL - lichen nitidus
© 2001-2009, DermAtlas
Image Name: Lichen_nitidus_5_031011   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: genital / penis   Age: 12 years
Contributor: Shahbaz A. Janjua, MD    
Description: uniform, 2 mm, grouped, flat topped, hypopigmented papules
Comments: This 12-year-old boy developed a slowly progressive asymptomatic papular eruption on his face, trunk, extremities, and penis 3 months earlier.
Related Images: All related Images  Lichen_nitidus_4_031011  Lichen_nitidus_3_031011  Lichen_nitidus_2_031011  Lichen_nitidus_1_031011 

DermAtlas: FOOT - lichen nitidus
© 2001-2009, DermAtlas
Image Name: Lichen_Nitidus_1_030922   File Type: jpg
Diagnosis: LICHEN NITIDUS   Category: papulosquamous eruptions
Body Site: foot   Age: 9 years
Contributor: Douglas Hoffman, MD    
Description: Shiny, flat topped, skin colored pinpoint papules on the dorsal surface of a nine year old's right foot. Patient was asymptomatic. Physical exam was otherwise normal. No treatment was recommended.
Comments: This child developed an asymptomatic eruption on the dorsal surface of the right foot. The papules became more widely disseminated over several months and resolved 18 months later without therapy. Note the

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Bernard A. Cohen, MD, Christoph U. Lehmann, MD

DermAtlas was last updated: Oct-28-2009
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