Three cases of lichen nitidus associated with various cutaneous diseases

Abstract

Lichen nitidus (LN) is an uncommon, usually asymptomatic cutaneous eruption characterized by the presence of multiple, small, flesh-colored papules. The epidemiologic and pathophysiologic characteristics of LN have not yet been defined. Furthermore, LN has rarely been described in association with other cutaneous diseases. We herein report 3 cases of LN associated with various cutaneous diseases, including lichen striatus, oral lichen planus, and psoriasis vulgaris.

Keywords: Lichen nitidus; Lichen planus; Lichen striatus; Oral cavity; Psoriasis.

Fig. 1

Physical examination of the patient 1 revealed well-defined, pinhead-sized, skin-colored to erythematous grouped papules (arrows) on the right upper back (A), and pinhead-sized, whitish papules in a linear configuration on the right arm (B). Histopathologic examination from the right upper back shows hyperkeratosis, acanthosis, hydropic degeneration of the basal cell layer, and 'claw clutching a ball' appearance (C), from the the right arm shows hyperkeratosis, focal parakeratosis, acanthosis, hydropic degeneration of the basal cell layer, superficial perivascular lymphocytic infiltration and perifollicular lymphohistiocytic infiltration (D) (C, D: H&E, ×100).

Fig. 2

Physical examination of the patient 2 revealed slightly erythematous plaques with whitish striae arranged lacy pattern on the dorsal surface on the tongue (A), and localized, relatively well defined, 2 to 3 mm sized, skin colored to slightly erythematous, grouped papules on both wrists (B). (C) Biopsy from the tongue shows hyperkeratosis, hypergranulosis, irregular acanthosis, hydropic degeneration of basal cells and band like infiltration of lymphocytes in the upper dermis (H&E, ×100).

Fig. 3

Physical examination of the patient 3 revealed scattered, relatively well-defined, erythematous, scaly plaques on the lower extremities (A), and scattered, well-defined, pinhead-sized, skin colored, glistening papules on the trunk (B). (C) Biopsy from the right knee shows parakeratotic mounds (Munro microabscesses), hyperkeratosis, acanthosis with elongation of rete ridges and dilated capillaries at the superficial dermis with perivascular lymphocytic infiltration (H&E, ×100).