Misleading clinical presentation of a palmar lichen nitidus masquerading as pompholyx

Lichen nitidus is usually a chronic localized disease of unknown etiology having multiple differentials. A 10-year-old boy presented with itchy, multiple, discrete, grouped, and minute papules with surrounding erythema in some and exfoliation in few others, involving the center of the right palm, the palmar aspect of the left little finger with few lesions over the dorsal surface of both the hands. The presenting feature misguided us with a few clinical points which are unusual in lichen nitidus. We report the case to highlight the clinical mimicry and limitations of clinical assessment for diagnosing lichen nitidus.