Case report: Comparative treatment course of generalized lichen nitidus: effectiveness of topical steroids versus maxacalcitol

Lichen nitidus is a chronic skin disease characterized by scattered shiny papules and is common among relatively young individuals. We report a persistent rash covering the body of a 6-year-old boy, unresponsive to prior treatments like moisturizers and topical steroids. Clinical examination revealed small yellow papules predominantly distributed on the trunk, around the eyes, and clustered around the elbow and knee fossa. Histopathological analysis showed a localized infiltrate of lymphocytes and basal epithelial cells, along with giant cells. The overlining rete ridges extended to surround the inflammatory cells, resembling a claw clutching a ball image. Topical treatment with alclometasone dipropionate ointment was more effective compared to maxacalcitol. Remarkably, after about 3 months of treatment, the rash had completely disappeared. We summarized treatments of lichen nitidus in Japan. Maxacalcitol had never been tried. In this report, we demonstrated the effectiveness of the steroid ointment compared to maxacalcitol through the clinical course.