From the Research
The first line treatment for lichen nitidus is typically no treatment, as it is often asymptomatic and may resolve spontaneously within a year, but for symptomatic cases, topical corticosteroids, such as triamcinolone 0.1% or betamethasone 0.05% cream, applied twice daily to affected areas for 2-4 weeks, can be considered. According to the most recent study 1, lichen nitidus is a rare inflammatory skin condition characterized by small, shiny, flat-topped papules, and its etiology remains unclear. The study highlights that LN is often asymptomatic, with papules primarily on the trunk, upper limbs, and genitalia, and diagnosis relies on characteristic histopathology.
Some key points to consider when managing lichen nitidus include:
- The condition is often benign and non-contagious, which may provide reassurance and reduce anxiety about the appearance of the small, flesh-colored papules characteristic of this condition.
- For pruritic or cosmetically bothersome cases, topical steroids can help reduce inflammation and alleviate symptoms.
- For more widespread cases, phototherapy (UVB or PUVA) may be considered, as seen in a case report where generalized lichen nitidus refractory to topical and systemic corticosteroids completely responded to PUVA 2.
- Antihistamines such as cetirizine 10mg daily or hydroxyzine 25mg at bedtime can help control itching.
- Topical calcineurin inhibitors like tacrolimus 0.1% ointment or pimecrolimus 1% cream are steroid-sparing alternatives, especially for sensitive areas like the face or genitals.
- Treatment should be reassessed after 4 weeks, and patients should be informed about the condition and its management options.
It's worth noting that other studies, such as 3, have reported successful treatment of lichen nitidus with hydroxychloroquine, but the most recent and highest quality study 1 does not mention this as a first-line treatment option. Similarly, studies 4 and 5 discuss the treatment of oral lichen planus, which is a different condition from lichen nitidus, and their findings may not be directly applicable to the management of lichen nitidus.