Lichen nitidus is an eruption of tiny, flesh-colored bumps on your skin. It’s a harmless condition that usually goes away on its own within a year.
It used to be considered a variant of lichen planus, but it’s now treated as an unrelated condition. Nitidus is Latin for “glossy,” referring to the sheen often seen on the tiny bumps.
Read on to learn more about lichen nitidus, including what it looks like and how it’s treated.
Lichen nitidus causes very small bumps (papules) on your skin. The papules are usually the same color as your skin. If you have lighter skin, they may look slightly pink. If you have darker skin, they may look slightly lighter or darker than the surrounding skin.
Where it appears
Lichen nitidus can appear anywhere on your body, but the most common locations are the:
- inside of the forearms
- back of the hands
In rare instances, it can spread to cover much of the body. This is called generalized lichen nitidus.
Size and appearance
The papules can range from the size of a pinpoint to that of a pinhead. They can also be:
- round or polygon-shaped
- clustered in groups
Lichen nitidus usually doesn’t cause any other symptoms, though the papules may itch sometimes.
Experts aren’t sure about the exact cause of lichen nitidus. The papules are the result of inflammation by white blood cells known as T lymphocytes. The T lymphocytes are a part of your immune system that helps to heal wounds.
No one’s sure why the T lymphocytes become active in lichen nitidus.
There’s no clear connection between lichen nitidus and race, skin type, or sex. But a majority of cases occur in children and young adults.
It may also accompany other conditions, including:
- lichen planus
- Crohn’s disease
- Down syndrome
- atopic dermatitis
- juvenile chronic arthritis
- congenital megacolon
A doctor can usually diagnose lichen nitidus by looking closely at your skin. They might also do a biopsy.
A biopsy is a small sample of skin cut from the site of the eruption. Before taking the sample, they’ll briefly freeze the area or give you local anesthesia. They’ll examine the sample using a microscope.
You may also be asked a few questions about:
- when you first noticed the bumps
- whether their appearance has changed over time
- whether the bumps are itchy
- whether you have any allergies
- whether any soaps or lotions seem to irritate the affected area
- whether you have a family history of eczema
Lichen nitidus doesn’t usually require any treatment.
In two-thirds of cases, the papules clear up on their own within a year. But discoloration in the area might linger for several more months or even years, in some cases.
If the papules are itchy or don’t seem to be getting any better, there are a few treatment options that can help.
Phototherapy uses natural sunlight or ultraviolet light to treat certain conditions. Both narrow-band UVB and UVA light have been used with some success. UV refers to the ultraviolet portion of the naturally occurring light spectrum, while B and A refer to the frequencies within the ultraviolet band.
You may need to do several treatment sessions before you see results. A 2007 case study involving two people with lichen nitidus found that the condition cleared up after 18 to 20 UVB light treatments.
These are ointments or gels containing inflammation-reducing corticosteroids, such as cortisone. Just make sure to only use them as directed by your doctor. Using them too often or over a long period of time can cause permanent thinning of the skin.
Topical calcineurin inhibitors
These include a cream called pimecrolimus and an ointment called tacrolimus. Calcineurin inhibitors help to slow the release of T cells by your immune system.
Remember, lichen nitidus results from an excess of T cells. Again, make sure to closely follow your doctor’s instructions, as using them too much can affect kidney function.
Antihistamines include medications, such as diphenhydramine (Benadryl), that help to treat cold or allergy symptoms. They can also help to reduce inflammation and itching caused by lichen nitidus. Diphenhydramine (Benadryl) is available as a topical anti-itch cream on Amazon.
Lichen nitidus is a harmless skin condition that usually clears up on its own within a year. But if you’ve had it for more than a year or the affected skin becomes itchy, consider making an appointment with a doctor for additional treatment.
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