Lichen nitidus – pathology
Histology of lichen nitidus
Scanning power view of lichen nitidus identifies a focal dermal inflammatory infiltrate enclosed within collarettes of epidermal acanthosis (Figures 1 and 2). Focal erosion of the epidermis in figure 1 indicates excoriation. Higher power view identifies a well circumscribed lymphohistiocytic infiltrate with multinucleated giant cells (Figures 3 and 4).
Differential diagnosis of lichen nitidus
Micropapular sarcoidosis: The inflammatory infiltrate is also seen focally within the papillary dermis, but is predominantly histiocytic forming non caseating epithelioid granulomas.
Lichen scrofulosorum: The non caseating granulomas are typically centred on the hair follicles or sweat ducts.
Papular granuloma annulare: Shows localized changes, but otherwise retains the typical infiltrate and collagen changes of granuloma annulare.
Draft 25 September 2011
- Skin Pathology (2nd edition, 2002). Weedon D
- Pathology of the Skin (3rd edition, 2005). McKee PH, J. Calonje JE, Granter SR
- Micropapular sarcoidosis. Acta Derm Venereol. 1998;78:299-319.
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