Cases reported "Lichen Nitidus"

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1/8. Generalized lichen nitidus.

    We report a 38-year-old man who presented with a generalized papular eruption that was clinically and histologically consistent with lichen nitidus. This patient's condition had been persistent for approximately 1 year; however, soon after assuming employment that entailed significant, regular sun exposure, the patient noted marked clearing of his lesions in sun-exposed areas. This case corroborates previous reports that suggest that generalized lichen nitidus can be successfully managed with ultraviolet light therapy.
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2/8. Generalized lichen nitidus successfully treated with an antituberculous agent.

    We describe a Japanese girl with generalized lichen nitidus. She had been exposed to mycobacterium tuberculosis at 6 years of age via her teacher. At 8 years of age, she developed severe contact dermatitis on sun-exposed areas after contact with Japanese lacquer trees. Shortly after, numerous tiny, shiny, flesh-coloured papules developed over the upper part of her body. At 10 years of age, she was exposed to a school outbreak of M. tuberculosis. Her eruption showed no response to topical corticosteroids or oral tranilast, but most of the papules completely disappeared after she had received oral isoniazid for 6 months.
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3/8. Purpuric generalized lichen nitidus: an unusual eruption simulating pigmented purpuric dermatosis.

    BACKGROUND: Generalized haemorrhagic lichen nitidus is rare. To our knowledge, this form of presentation has only been reported once. OBJECTIVE: To describe a new case of generalized haemorrhagic lichen nitidus simulating a pigmented purpuric dermatosis. methods AND RESULTS: We document a 24-year-old man who presented with an 8-month history of a progressive non-pruritic, red-brown papular eruption on the dorsa of the feet, ankles and distal third of the legs. A diagnosis of Schamberg's progressive pigmentary dermatosis was made, and no treatment was prescribed. Two months later, the lesions had extended to the abdomen, groins, forearms, elbows and wrists. biopsy of the skin of the right foot revealed lesions typical of lichen nitidus with subepidermal extravasation of red cells and capillary wall hyalinization. macrophages and T lymphocytes were abundant in the infiltrate. CONCLUSION: Purpuric generalized lichen nitidus should be included in the differential diagnosis of pigmented purpuric dermatoses.
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4/8. Condyloma with lichen nitidus.

    A 32-year-old black man presented with two separate eruptions on his penis (Figure). He has had a 10-year history of asymptomatic 1-3 mm shiny papules on the shaft of his penis. He also has had one asymptomatic verrucous brown plaque 1.5 cm in diameter on his penis. A small shave biopsy was performed for each process. The former showed lymphocytes and histocytes in the papillary dermis in a "ball-in-claw" relation to the rete ridges of the epidermis. The latter showed an acanthotic epidermis with papillomatosis. Diagnoses of lichen nitidus and condyloma acuminata were respectively made. As the shiny papules did not bother the patient, but he wanted to be rid of the verrucous plaque, only the latter was treated. Liquid nitrogen was applied to the plaque. The patient was also given podofilox 0.5% gel to apply to the condyloma overnight on Monday, Tuesday, and Wednesday, with a 4-day respite. This cycle was to be repeated for 3 more weeks. He was examined several more times and treated with cryotherapy and podofilox gel with the near disappearance of the condyloma over 4 months.
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5/8. Two cases of generalized lichen nitidus treated successfully with narrow-band UV-B phototherapy.

    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.
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6/8. Recurrent generalized lichen nitidus associated with amenorrhea.

    A case of recurrent generalized lichen nitidus is reported. The eruptions developed in the proliferative phase of the menstrual cycle, but there has been a marked improvement after administration of estrogen and progesterone for the treatment of amenorrhea. Hormonal factors may play a role in the development of lichenoid tissue reaction in the lesions of this disease.
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7/8. A case of generalized lichen nitidus with Koebner's phenomenon.

    A 12-year-old boy was seen in our department with a three year history of eruptions on his back consisting of normal colored or slightly reddish, pinhead-sized papules, which had gradually spread to his trunk within the previous year. Four days before the first visit, May 13, 1992, the eruption involved his entire extremities. On the back side of his lumbar region, Koebner's phenomenon was observed. He had received several medications for more than two years to treat this eruption in several hospitals, but none were effective. He was in good general health. Mantoux reaction was negative two months after BCG injection. Histopathologic features of the papules included focal epidermal hyperplasia and elongation of the rete ridges in a narrow area and a well demarcated dense lymphohistiocytic infiltrate on the papillar layer. Biscoclaurine alkaloids (20 mg/day) and Jumi-haidoku-to (TJ-6; 7.5 g/day) were administered to the patient after the biopsy. No topical ointments were applied. Two weeks after of these treatments, he reported moderate pruritus on the back. The eruption diminished rapidly within 2 weeks after the therapy began. Almost all the eruptions were cured within one year. Mantoux reaction developed 8 x 8 mm erythema two and half months after the treatment began, and it was significantly positive (23 x 30 mm) 6 months later.
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8/8. Improvement of lichen nitidus after topical dinitrochlorobenzene application.

    Recently, a relationship between immunologic alterations and the development of lichen nitidus (LN) lesions has been described. We treated LN lesions with topical dinitrochlorobenzene (DNCB) application in a patient with peripheral CD4 T lymphocytopenia. After 4 months, the eruption cleared. We investigated histologically and immunohistochemically biopsy specimens obtained before and after treatment. Our result suggests that local alterations of the pattern of cells and cytokines by topical DNCB application could have contributed to the resolution of the LN lesions.
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