ABSTRACT
BACKGROUND: Facial papules are a feature of several clinical conditions and may present both diagnostic and therapeutic challenges. AIM: To describe a grouped papular eruption on the nose and adjoining cheeks that has not been well characterized previously. MATERIALS AND METHODS: A series of consecutive patients with a papular eruption predominantly involving nose and cheeks were evaluated, treated and followed up prospectively at tertiary care centers. Demographic details, clinical features, histopathology and response to treatment were recorded. RESULTS: There were five men and six women (mean age 29.9 ± 6.9 years) who had disease for a mean duration of 17.3 ± 11.1 months. All patients presented with a predominantly asymptomatic eruption of monomorphic, pseudovesicular, grouped, skin colored to slightly erythematous papules prominently involving the tip of nose, nasal alae, philtrum and the adjoining cheeks. A total of 15 biopsies from 11 patients were analyzed and the predominant finding was a dense, focal lymphoid infiltrate restricted to the upper dermis with basal cell damage and atrophy of the overlying epidermis. The eruption ran a chronic course from several months to years. LIMITATIONS: Direct immunofluorescence could not be performed except in one case. Immunohistochemical stains for CD4 and CD8 could not be done owing to nonavailability. Phototesting was undertaken in one patient only. CONCLUSION: Small grouped papules on the nose and adjoining skin with a lichenoid histopathology appear to represent a distinct clinicopathological entity. It may be related to actinic lichen nitidus/micropapular variant of polymorphous light eruption.
Subject(s)
Dermatologic Agents/therapeutic use , Facial Dermatoses/diagnosis , Lichen Nitidus/diagnosis , Lichenoid Eruptions/diagnosis , Nose/pathology , Adult , Facial Dermatoses/complications , Facial Dermatoses/therapy , Female , Humans , Lichen Nitidus/complications , Lichen Nitidus/therapy , Lichenoid Eruptions/complications , Lichenoid Eruptions/therapy , Male , Phototherapy/methods , Young AdultABSTRACT
Lichen nitidus is a rare, chronic dermatosis which occurs more often in children than in adults. It presents with tiny, monomorphous, lichenoid, mostly asymptomatic papules in regional or disseminated distribution which show a pathognomonic histological pattern. The pathogenesis is unclear; however, immunologic phenomena and genetic factors are under discussion. In rare cases, an association with other dermatoses and systemic diseases has been described. Moreover, medical treatments have been incriminated as triggers. Considering the self-limited course in mostly young patients, treatment must be thoroughly weighed. Possible therapeutic options include topical corticosteroids and calcineurin inhibitors as well as oral antihistamines, corticosteroids and narrow-band ultraviolet B phototherapy. Lichen striatus is an acquired, usually asymptomatic dermatosis occurring mostly in preschool children. The characteristic feature is the arrangement of small, flat, light red- to skin-colored papules along the lines of Blaschko. Therefore, a postzygotic mutation of epidermal progenitor cells induced to express new surface antigens by trigger factors as infections, vaccinations or trauma with consecutive immune reaction is assumed. Nail involvement of the affected limb can rarely occur. Lichen striatus usually heals without scarring within several months, so that therapies with severe side effects are obsolete. Mild topical corticosteroids or calcineurin inhibitors may be used, especially if patients exceptionally suffer from pruritus. A postinflammatory hypopigmentation can persist for months to years.
Subject(s)
Lichen Nitidus/diagnosis , Lichenoid Eruptions/diagnosis , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Calcineurin Inhibitors/therapeutic use , Child , Child, Preschool , Diagnosis, Differential , Female , Histamine Antagonists/therapeutic use , Humans , Lichen Nitidus/pathology , Lichen Nitidus/therapy , Lichenoid Eruptions/pathology , Lichenoid Eruptions/therapy , Male , Prognosis , Skin/pathology , Ultraviolet Therapy , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Lichen Nitidus/diagnosis , Lichen Nitidus/therapy , Lichen Nitidus , Vitiligo/complications , Vitiligo/therapy , Phototherapy/methods , Phototherapy , Hand Dermatoses/complications , Hand Dermatoses/diagnosis , Leg Dermatoses/complications , Leg Dermatoses/diagnosis , Parakeratosis/complicationsSubject(s)
Dermatitis, Contact/diagnosis , Lichen Nitidus/chemically induced , Lichen Nitidus/diagnosis , Plant Extracts/toxicity , Dermatitis, Contact/pathology , Diagnosis, Differential , Humans , Lichen Nitidus/pathology , Male , Parthenogenesis , Patch Tests/methods , Tanacetum parthenium/toxicity , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Middle Aged , Lichen Nitidus/diagnosis , Lichen Nitidus/radiotherapy , Phototherapy/trends , PUVA Therapy/methods , Anti-Allergic Agents/therapeutic use , Lichen Nitidus/complications , Lichen Nitidus/physiopathology , Immunotherapy/trends , Dinitrochlorobenzene/therapeutic useABSTRACT
BACKGROUND: Narrow-band ultraviolet (UV) phototherapy has not been used in the treatment of lichen nitidus. AIM: To report two cases of generalized lichen nitidus successfully treated with narrow-band UV-B phototherapy. METHODS: A 7-year-old girl presented with a persisting, asymptomatic, papular eruption refractory to topical steroid for 3 months. Another 10-year-old boy presented with an asymptomatic papular eruption present for 6 months. The histopathologies of both lesions were consistent with lichen nitidus. The lesions were treated with narrow-band UV-B phototherapy. RESULTS: The lesions of the patients were almost completely cleared after the 30th and the 17th irradiation, respectively. CONCLUSIONS: Narrow-band UV-B may be an effective alternative therapy for the treatment of generalized lichen nitidus unresponsive to common therapies.