What Is Lichen Nitidus?

Medically Reviewed By Clare Wightman MS, PAC
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Lichen nitidus is a skin condition that causes tiny skin-colored spots to form on the skin. It is seen mostly in children and young adults. Lichen nitidus commonly affects areas such as the limbs, abdomen, chest, and genitalia.

Most cases of the condition are asymptomatic and usually not a cause for concern. It is rarely serious, but some cases may require treatment.

This article will explain what lichen nitidus is, its symptoms, causes, and treatment.

What is lichen nitidus?

hands on a blanket
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Lichen nitidus is an inflammatory skin condition that presents as shiny, skin-colored spots. It can develop on any part of the body, including the:

  • chest
  • abdomen
  • limbs
  • neck
  • palms
  • shaft of the penis
  • soles of the feet
  • nails

The condition is generally not serious and typically resolves within a few months to 1 year. In rare cases, symptoms may persist and lead to cosmetic problems.

Is it rare?

Lichen nitidus is a rare condition.

Who gets it?

Lichen nitidus can affect anyone but commonly develops in children and young adults. People between the ages of 37 and 52 with the condition tend to experience symptoms on their palms.

Lichen nitidus affects males and females equally.

Read more about skin conditions here.

What are symptoms of lichen nitidus?

Lichen nitidus presents as shiny, skin-colored spots
Lichen nitidus presents as shiny, skin-colored spots

Lichen nitidus presents as multiple flesh-colored bumps 1–2 millimeters in diameter. They usually have the following features:

  • shiny or glistening appearance
  • fleshy pink to dark brown
  • size of a pinhead
  • flat-topped or dome-shaped 
  • grouped or scattered
  • itchy in rare cases

Rashes with lichen nitidus can also erupt where the skin has been scratched or traumatized. This is known as the Koebner phenomenon.

Sometimes, the spots can have unique features when they develop in peculiar areas such as the:

  • Nails: Lichen nitidus can leave vertical grooves and ridges on the nail plate. It can also cause thickening, ridging, pitting, or detachment of the nails.
  • Oral mucosa: The oral mucosa is the membrane lining your inner mouth. Lichen nitidus spots in this area often have a flat, grayish appearance.

In people with darker skin, lichen nitidus spots can have a light-colored appearance.

When should you contact a doctor?

Lichen nitidus is typically not a cause for concern.

However, different skin conditions can display similar symptoms. You may wish to have your doctor perform a diagnosis to rule out other possible causes.

What causes lichen nitidus?

According to research, the cause of lichen nitidus is unknown.

Lichen nitidus was previously thought to be a variant of lichen planus, a condition that causes swelling and irritation in different parts of the body. However, this theory is no longer accepted.

Current research suggests that lichen nitidus develops when white blood cells called T lymphocytes become inflamed.

T lymphocytes are a part of your immune system, your body’s natural defense mechanism.

Read more about lymphocytes here.

Conditions it may accompany

There may be a link between lichen nitidus and a range of other conditions. However, further research is needed.

Other conditions that may be associated with lichen nitidus include:

  • Crohn’s disease: This is a type of inflammatory bowel disease that causes parts of the digestive system to become inflamed. It can cause diarrhea, weight loss, and cramps.
  • Niemann-Pick disease: This is a genetic condition in which your cells cannot metabolize cholesterol and other fatty substances.
  • Amenorrhea: This is the absence of a monthly menstrual cycle.
  • Down’s syndrome: This occurs when a person has an extra chromosome. It can cause a flat nasal bridge and short stature, among other symptoms.
  • Advanced HIV: This virus impairs your immune system and makes it less effective against infections and diseases.
  • Hepatitis C: This is a liver infection that can cause severe liver damage. It results from the activities of the hepatitis C virus.
  • Vitiligo: This occurs when pale white patches form on the skin. It results from a lack of melanin pigment in the skin.
  • Lichen spinulosus: This is a rare, benign skin condition that presents as spiny, rough spots. It commonly affects children and adolescents.

How do you treat lichen nitidus?

Lichen nitidus is usually harmless and asymptomatic. It typically does not require treatment.

Because it is rare, there have been few studies on effective medications to treat the condition. However, if you have cosmetic concerns or other issues such as itching, contact a dermatologist.

To relieve symptoms of lichen nitidus, a dermatologist may recommend:

  • immunosuppressants such as cyclosporine and topical calcineurin inhibitors to limit atypical immune activity
  • retinoids such as acitretin and systemic isotretinoin to clear up skin spots
  • antifungals such as itraconazole to prevent infection

Other treatments for lichen nitidus include:

Topical corticosteroids

These are a type of steroid treatment that come in the form of lotions, gels, and ointments. You apply them directly to your skin to help reduce inflammation and irritation.

Types of topical corticosteroids include clobetasone, hydrocortisone skin cream, and hydrocortisone.

Antihistamines

Antihistamines can help treat itchiness. Doctors administer them as part of treatment for various conditions, including:

Phototherapy

This uses artificial light to remove skin lesions.

Types of phototherapy include:

  • Photochemotherapy (PUVA): This uses a type of ultraviolet (UV) radiation to activate a photosensitive drug in the body.
  • Narrow UVB rays: This uses a specific wavelength of ultraviolet B (UVB) light to treat skin problems.

How do doctors diagnose lichen nitidus?

Doctors can often diagnose lichen nitidus from its appearance. However, they may wish to perform a biopsy to further confirm the diagnosis.

A biopsy involves taking a small sample of affected skin and studying it under a microscope. This can help to rule out other skin conditions.

How do you prevent lichen nitidus?

Lichen nitidus is not preventable.

Summary

Lichen nitidus is a rare, inflammatory skin condition that presents as shiny, skin-colored bumps. It typically develops in children and young adults and commonly affects the upper limbs.

Researchers do not know the exact cause of lichen nitidus. However, it may be linked to genetics or inflammation of T lymphocytes, a type of white blood cell.

Doctors typically diagnose lichen nitidus from its appearance. They may also perform a biopsy to confirm the results.

Treatments include phototherapy, antihistamines, and topical corticosteroids. Contact your doctor if you have concerns about symptoms of lichen nitidus.

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Medical Reviewer: Clare Wightman MS, PAC
Last Review Date: 2022 Sep 28
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