Coalescing skin-colored papules
The rash’s distinct clinical appearance and the patient’s age pointed to an uncommon diagnosis.
Topical treatment can help manage the condition
Most patients experience spontaneous resolution of lesions within several years; treatment is primarily for symptomatic or cosmetic purposes. When pruritus is present, topical corticosteroids and oral antihistamines may help (eg, hydrocortisone 2.5% cream and oral hydroxyzine). Topical calcineurin inhibitors, such as pimecrolimus cream, have also been reported as an effective therapy in children with lichen nitidus.1 In patients with generalized lichen nitidus who have not responded to topical corticosteroids, phototherapy can be used.5 There are no randomized controlled trials to assess the effectiveness of different types of treatments.
In this case, the patient was advised to start using an over-the-counter topical steroid, such as 1% hydrocortisone cream, to help control pruritus. He was scheduled for a follow-up appointment in 3 months.
