Having good skin may seem like what females want but nowadays we are seeing both male and females paying close attention to their skin health. There are many kinds of treatment that can help improve overall skin, especially the face. However, there are certain conditions of the skin causing a person unable to have that clear and glowing skin. In this DoctorOnCall’s article, we will be learning about lichen nitidus.

            Lichen nitidus is a skin condition characterised by inflammation. It is a rare skin disease. It is used to be considered as a variant of lichen planus due to almost similar symptoms and possible causes but it is actually two different entities. Lichen planus is also a skin condition caused by inflammation. Lichen nitidus and lichen planus are both caused by autoimmune disorder which means the immune cell attacks the cell of the human body itself whereas lichen nitidus. The biggest difference between the two skin conditions is the size of the bumps and its surfaces.

            Lichen nitidus usually begins in childhood, most often in school-aged children. However, there are also cases of lichen nitidus in older adults. Both females and male can be affected by this skin condition. Although it is said to be caused by autoimmune reaction, it is not exactly known what may be causing the disease as there are many factors that can make a person prone to have this skin issues such as those with Crohn disease, HIV infection, Down syndrome and atopic dermatitis. There are also cases of lichen nitidus occurring in those with patients after tattoos, receiving treatments for hepatitis C and cancer treatment. Based on the possible causes and factors associated with lichen nitidus, immune reaction or immune alterations is said to be the underlying issues leading to lichen nitidus. In some cases, it may be hereditary, meaning a person with a close family member having lichen nitidus could have higher chance for developing lichen nitidus.

            Typically, lichen nitidus presents as a bumpy skin eruption on the arm, back of hands, penis, chest, abdomen and buttocks. Palms and soles may be affected with one side or both being affected. Any site can actually be affected by lichen nitidus including the face and lining of the mouth. Specifically for lichen nitidus involving the mouth, it features tiny grey-white flat bumps inside the cheek, white plaques on tongue and roof of the mouth (hard palate) and may resemble oral lichen planus. The bumps are usually pinhead size of 1-2 millimetres diameter, round or polygonal shape, flat-topped, shiny and skin coloured but are less common in case it can be in yellow, red-brown or violet colour. In dark skinned patients, the colour of the bumps may be lighter or darker than their initial skin colour. It can be itchy but at most times it does not cause nay symptoms. The bumps can be clustered in groups and forming plaques. Changes in nails can be seen in some patients, particularly adults which include snail pitting, ridging of nail plates and splitting of free nail edges.

            Since it is a quite rare skin condition, it is best for patients to get checked by a dermatologist when they have symptoms. Dermatologists will run examinations such as dermatoscope and possibly skin biopsy to confirm it. Lesions can go away within months and up to a year. No treatment is needed as it usually does not cause symptoms and can go away within 12 months. Treatments can help reduce symptoms such as itchiness, skin rash or in prolonged cases and improve the skin condition. This includes topical corticosteroids, topical calcineurin inhibitors such as tacrolimus or pimecrolimus, phototherapy such as sunlight, narrowband UVB phototherapy or photochemotherapy (PUVA) and contact sensitisation with DNCB or diphencyprone. In severe cases, systemic treatments which means treatments further and broader than topical one may be considered such as ciclosporin, retinoids and corticosteroids. Post-inflammatory hyperpigmentation or dark coloured at the site of the healed affected skin may persist for months and even in some cases for years.

            It can be concluded that lichen nitidus is a rare inflammatory skin disease which usually does not cause symptoms. It usually affects children but can also affect adults. It is a self-limiting disease as the skin condition will be improved within 12 months. Although in most cases treatment is not needed, some people may want to get treated especially when there are symptoms. Treatments are initially topical before systemic one is given. Since it is a rare disease, it is best for patients to get checked by doctors to make sure it is not caused by other skin problems. Due to the fact it is usually caused by many reasons, it is wise to have discussion and get medical advice to ensure the skin condition is not the aftermath or the sign for an underlying serious health problem. Any concern of skin problems that interferes with daily life routine should be addressed to doctors.

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By Alexander James

Beau Alexander James: Beau, a mental health advocate, shares personal stories, coping strategies, and promotes mental health awareness and understanding.