J Korean Med Sci.  2007 Feb;22(1):163-166. 10.3346/jkms.2007.22.1.163.

Generalized Lichen Nitidus Successfully Treated with Narrow-band UVB Phototherapy: Two Cases Report

• Do MO
• Kim MJ
• Kim SH
• Myung KB
• Choi YW

• KMID: 1713260
• DOI: http://doi.org/10.3346/jkms.2007.22.1.163

Abstract

Lichen nitidus (LN) is an uncommon chronic inflammatory skin disease composed of numerous, tiny, shiny, flesh-colored papules that are predominantly observed on the chest, abdomen, glans penis and upper extremities. The distribution of LN is most often localized, but in some cases it can become generalized. Because LN tends to be asymptomatic and presents spontaneous resolution within several years, it usually does not require treatment except in symptomatic, persistent and generalized cases. We describe a 28-yr-old man and a 7-yr-old boy with generalized LN where both cases improved with narrow-band ultraviolet B (NB-UVB) phototherapy plus topical steroid ointment. Both patients noted improvement within the first three treatments and showed almost complete resolution after 18 and 20 treatments, respectively. NB-UVB phototherapy may be an effective alternative therapy for the treatment of generalized LN, even for those patients in their childhood.

Keyword

Skin Diseases; Lichenoid Eruptions; Lichen Nitidus; Narrow-band UVB; Phototherapy; Ultraviolet Therapy

MeSH Terms

*Ultraviolet Therapy
PUVA Therapy
Male
Lichen Nitidus/pathology/*radiotherapy
Humans
Child
Adult

Figure

• 

  Fig. 1 (A) Numerous flesh-colored, flat, shiny papules are distributed on the abdomen. (B) After only 3 sessions of NB-UVB irradiation, the papules show marked flattening.

• 

  Fig. 2 Biopsy of a papule from the abdomen shows the localized lymphohistiocytic infiltrate in an expanded dermal papilla and the downward extension of the rete ridges at the lateral margin of the infiltrate, which produces a typical 'claw clutching a ball' configuration (H&E, ×100).

• 

  Fig. 3 (A) Numerous discrete flesh-colored glistening papules presented on the abdomen. (B) After the 15th session of NB-UVB phototherapy, most of the papules had completely disappeared.

Reference

1. Lapins NA, Willoughby C, Helwig EB. Lichen nitidus: A study of forty-three cases. Cutis. 1978. 21:634–637.

2. Randle HW, Sander HM. Treatment of generalized lichen nitidus with PUVA. Int J Dermatol. 1986. 25:330–331.

3. Chen W, Schramm M, Zouboulis CC. Generalized lichen nitidus. J Am Acad Dermatol. 1997. 36:630–631.

4. Lee SD, Kim MY, Baek SC, Houh D, Byun DG. Two cases of lichen nitidus treated with diphenylcyclopropenone immunotherapy. Korean J Dermatol. 2001. 39:1432–1434.

5. Ocampo J, Torne R. Generalized lichen nitidus -report of two cases treated with astemizole. Int J Dermatol. 1989. 28:49–51.

6. Libow LF, Coots NV. Treatment of lichen planus and lichen nitidus with itraconazole. Cutis. 1998. 62:247–248.

7. Kubota Y, Kiryu H, Nakayama J. Generalized lichen nitidus successfully treated with an antituberculous agent. Br J Dermatol. 2002. 146:1081–1083.

8. Lucker GP, Koopman RJ, Steijlen PM, Valk PG. Treatment of palmoplantar lichen nitidus with acitretin. Br J Dermatol. 1994. 130:791–793.

9. El-Ghorr AA, Norval M. Biological effects of narrow-band (311nm TL01) UVB irradiation. a review. J Photochem Photobiol B. 1997. 38:99–106.