From the Research
Lichen nitidus typically doesn't require treatment as it's usually asymptomatic and resolves on its own over time. For symptomatic cases, the most effective treatment approach should prioritize reducing inflammation and modulating the immune response in the skin. Considering the available evidence, topical corticosteroids like triamcinolone 0.1% cream applied twice daily for 2-4 weeks are the first-line treatment to reduce inflammation and itching 1. Additionally, antihistamines such as cetirizine (10mg daily) or diphenhydramine (25mg every 6 hours) can help control itching. For persistent cases, phototherapy with narrowband UVB three times weekly for 6-8 weeks may be effective, as demonstrated in a case report where narrow-band UV-B phototherapy successfully treated generalized lichen nitidus 2. Topical calcineurin inhibitors like tacrolimus 0.1% ointment twice daily can be used as steroid-sparing agents, especially for facial or genital lesions, given their effectiveness in treating similar conditions like lichen simplex chronicus 3. Oral retinoids such as acitretin (25-50mg daily) are reserved for severe, widespread cases. It's also noteworthy that natural sunlight therapy has been reported as an effective treatment alternative for pediatric generalized lichen nitidus 4. Patients should also avoid potential irritants, use gentle soaps, and apply moisturizers regularly to prevent skin dryness which can worsen symptoms. Given the rarity of the condition and the variability in treatment responses, the choice of treatment should be individualized, considering the severity of symptoms, the extent of the disease, and the patient's overall health status. The most recent and highest quality study supporting the use of narrowband UV-B phototherapy for generalized lichen nitidus is from 2, which highlights its potential as an effective treatment modality. However, the treatment approach must be tailored to each patient, taking into account the specific characteristics of their condition and the potential benefits and risks associated with each treatment option.