Lichen Nitidus: Treatment, Procedure, Cost and Side Effects

There are no other terms for lichen nitidus.

Lichen nitidus is a rare and chronic skin disease. The exact cause of this disease is not known but they appear as tiny, skin-colored, glistening bumps on the surface of the skin. Lichen nitidus mahy result from abnormal and unknown inflammatory activity in skin cells.

Lichen nitidus is characterized by 1–2 mm, shiny, flat-topped, discrete and uniform, clusters of tiny pale flesh-colored or reddish-brown papules. They appear as hypopigmented bumps against dark skin. Lichen nitidus bumps are located usually on the chest, abdomen, arms and genital areas, including the penis. These papules can occur in one place, clear up on its own and then occur again in some other place. In rare cases, these bumps caused by lichen nitidus can cause itches. These itches can grow intense and result into fever.

In general, lichen nitidus grows and disappears on its own. Thus, many a times, no treatment is required. However, if the post-inflammatory hyperpigmentation persists for months or years, treatment is done to cure this. Light, like sunlight, narrowband UVB phototherapy and photochemotherapy (PUVA) is used to provide relief to patients. Topical corticosteroids, topical calcineurin inhibitors (tacrolimus and pimecrolimus) medications may be used to treat lichen nitidus. Also, contact sensitisation with DNCB or diphencyprone may be used. In many cases, systemic treatments may be considered. This treatment includes corticosteroids, ciclosporin, retinoids, isoniazid et cetera.

In order to diagnose lichen nitidus, doctors may take small sample of the skin tissue. A skin biopsy is needed to confirm the condition.

Lichen nitidus is a self-limiting condition that lasts for a few months to a year. The condition usually clears up on its own without treatment. However, treatment may be done if the appearance causes itches or other problems. Doctors may prescribe one or more of the following treatments. Corticosteroids may help to reduce the inflammations and bumps associated with lichen nitidus. Another topical or oral treatment can include the use of retinoid. Retinoid is the synthetic version of Vitamin A. Another topical drug which is known as tacrolimus (Protopic) helps to suppress the immune response and this may be helpful for treating lichen nitidus. Antihistamines act against a protein called histamine which is involved in causing inflammatory activity. An oral or topical antihistamine may relieve the person from itching associated with lichen nitidus. Phototherapy is another method to treat the bumps of lichen nitidus. Phototherapy is a type of light therapy that uses various light sources to penetrate deep into the skin and cure the bumps and papules. Ultraviolet A (UVA) light, narrow band ultraviolet B (UVB) light and photochemotherapy (PUVA) are the various kinds of light used for treating lichen nitidus in combination with drugs.

People should consult a doctor as early as possible if tiny bumps or a rash-like condition appears on the skin for no apparent reason, such as a known allergic reaction or contact with poison ivy. People better get a prompt and accurate diagnosis because a number of conditions can cause skin reactions and skin irritations. They should consult a doctor if there be other noticeable symptoms such as fever, itching and pus or ooze from a rash. After medical diagnosis and tests, people will be eligible for treatment.

People can get bumps and rashes on the skin for many different causes. If these are caused due to hormonal causes or infections or allergic reactions, then people do not need to undergo treatment for lichen nitidus. Hence, it is vital to detect the exact cause of the rashes on the skin.

The side effects of the drugs used for the treatment of lichen nitidus depends on the type of drug used and its chemical composition and also its sensitivity to the individual patient. Side effects of corticosteroid vary depending on whether corticosteroid has been used as an ointment applied directly to the skin (topical) or taken as a pill (oral). Long-term use of topical corticosteroids can cause thinning of the skin, a gradual lessening of the treatment effect and other skin problems. Long-term use of oral corticosteroids can cause weakening of the bonesand bone density (osteoporosis), diabetes, high blood pressure and high cholesterol levels in the body. Topical use of retinoid in the treatment may cause irritation of the skin. Because retinoid can cause birth defects, it should not be used by women who are pregnant or who might become pregnant. Possible side effects of tacrolimus include stinging, burning and itching at the site where the medicine is applied. This medication cannot be used in conjunction with phototherapy method. Patients should limit exposure to the sun while using tacrolimus and they should not use tanning beds during treatment. Also, it is important to avoid sun exposure for a couple of days after having phototherapy treatment. Doctors advise the need to wear special UV-absorbing sunglasses for a couple of days to protect the eyes.

Lichen nitidus is a benign disease. This is a self limiting condition and the bumps or rashes fade away on their own in a couple of months. They are not associated with mortality or complications. After treatment, it is important to avoid sun rays and wear protective shields to prevent sunlight.

The rashes and tiny bumps of lichen nitidus do not last long and go away after a certain time on their own. They take around two or three months to fade away in most of the cases. If not, the longest they stay is for six to eight months, in extreme cases. There may remain tiny white spots after the rashes disappear. These white spots can later show up. So it is important to prevent it by being under shade or taking other means to prevent those spots from being exposed to light.

The price of lichen nitidus treatment varies for each person and it depends on the extent of treatment necessary. Skin biopsy tests and treatment cost may sum upto Rs 5000/-. Phototherapy can incur greater costs. Topical or oral consumption of medications do not cost more than Rs 800- Rs 1000/-

Lichen nitidus can come back even after treatment, although it disappears on its own even without treatment. These rashes and bumps can reappear on the surface of the skin even after treatment and to prevent it from recurring, it is important to take precautionary measures. Keeping the exposed parts of the body covered from sunlight or fluorescent light or any other kinds of light is important.