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LETTER TO EDITOR
Year : 1995  |  Volume : 61  |  Issue : 1  |  Page : 64-65

Generalized lichen nitidus associated with chronic renal failure




Correspondence Address:
M Archana Goyal


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Source of Support: None, Conflict of Interest: None


PMID: 20952887

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How to cite this article:
Goyal M A, Kachhawa D, Kalla G, Vyas M. Generalized lichen nitidus associated with chronic renal failure. Indian J Dermatol Venereol Leprol 1995;61:64-5

How to cite this URL:
Goyal M A, Kachhawa D, Kalla G, Vyas M. Generalized lichen nitidus associated with chronic renal failure. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Nov 15];61:64-5. Available from: http://www.ijdvl.com/text.asp?1995/61/1/64/4141



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Lichen nitidus (LN) is usually localized eruption of micropapular, skin-coloured, shiny, dome-shaped, grouped lesions of unknown aetiology. Recently we had an interesting case of generalised LN associated with chronic renal failure (CRF) because of calculus in right ureter and left renal pelvis. LN eruption showed improvement with improved CRF.

A 12-year-old boy with CRF presented with pin-point to pin-head sized, dome shaped skin coloured, shiny papules all over the body sparing scalp and face of 5 days duration. The lesions also showed grouping and Koebner's phenomenon at places. These were predominantly over both extremities, trunk, abdomen, palms and penis. On the palms the lesions were mimicking pompholyx. Nails and oral mucosa were free. The patient was clinically diagnosed as having lichen nitidus and it was subsequently proved by histopathology, he was prescribed moisturizing cream only for his skin ailment. 7-10 days after lesions started regressing leaving slight scaling. The lesions disappered in next 10-12 days. At the time of regression patient also showed improvement in CRF by increasing urinary output and blood urea from 203 mg/dl to 86 mg/dl and serum creatinine 13 mg/dl to 9.3 mg/dl.

Histology showed circumscribed infiltrate of lymphocytes and histiocytes near the upper dermis. Epidermis above the infiltrate was flattened and showed hydropic degeneration with absence of basal cell layer and parakeratosis above the infiltrate. At each lateral margin of infiltrate, rete ridges tend to extend downward and seemed to clutching the infiltrate in manner of a claw clutching a ball.

LN can involve any part of body but lesions are mostly localized.[1] Few cases of generalized LN were described.[2] It was also described in association with Crohn's disease.[3] In our case the association with CRF was not merely coincidental, the eruption subsided with decrease in blood urea and serum creatinine, probably this elevated blood urea and serum creatinine were the precipitating factor for LN. Histopathologically LN provides characteristic diagnostic features which can easily be differentiated from lichen planus.



 
  References Top

1.Black MM. In: Rook's Text book of Dermatology. 5th edn. Oxford. Blackwell Scientific Publications 1992;1696-8.  Back to cited text no. 1    
2.Wall LM, Heenan RJ, Papadimitriav JM. Generalized lichen nitidus : A case report. Australas J Dermatol 1985;26:36-40.  Back to cited text no. 2    
3.Kint A, Meysman B, Bugingo G, Verdonk G, Huble F. Lichen nitidus and Crohn's disease. Dermatologica 1982;164:2727.  Back to cited text no. 3    




 

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