Dermoscopy of lichen nitidus: a study of 20 cases

Lichen nitidus (LN) is a chronic inflammatory lichenoid dermatosis, commonly seen in childhood or early adulthood. In this case series, we studied the various dermoscopic features of LN and correlate them with clinical variants, duration of disease and histopathology. A total of 20 patients of LN were studied. The mean age was 25.7 years with 45% and 55% male and female, respectively. The median duration of disease was 6 months. The dermoscopic findings seen on non-polarizing mode were-shiny elevated surface with absence of skin markings (100%), scaling (70%), radial ridges (50%) and central depression (35%). Findings seen on polarizing mode were-hypopigmentation (100%), brown shadow (70%), linear vessels (65%), accentuation of surrounding reticulate pigment network (65%), diffuse erythema (45%). Newer findings seen were central grey-brown structureless areas (30%), speckled brown pigment (40%), curvilinear vessels (50%), branching/serpentine vessels (20%), radial vessels (10%), white dots and streaks (30%) and ring-in-ring appearance (5%). LN presents fairly distinctive dermoscopic features and dermoscopy can be a non-invasive, painless aid in differentiating it from close clinical differentials and avoid the need for a biopsy, especially in children.