Transepidermal elimination and/or perforation of the epidermis is seen in a variety of conditions but has only rarely been reported in association with lichen nitidus. We describe a case of lichen nitidus with the unique finding of epidermal perforation, a feature that made the usual straightforward diagnosis of lichen nitidus much more difficult.
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Article Synopsis
- Perforating lichen nitidus is a rare skin condition, with only about 11 cases documented globally, usually affecting young males in areas that experience frequent mechanical irritation like hands and elbows.
- The condition features distinct histopathological characteristics, including a specific lymphohistiocytic inflammation within the skin layers, leading to the elimination of dermal materials through the skin surface.
- This case study is notable as it describes the first instance of perforating lichen nitidus in a patient with atopic dermatitis undergoing dupilumab treatment, indicating that while atopic dermatitis improved, the lichen nitidus worsened, hinting at a unique underlying mechanism for the condition.
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