Shiny shingles

Lichen nitidum (syn. granuloma nitidum) is a rather rare dermatosis, the etiology and pathogenesis of which are unclear, considered as a variant of lichen planus, a miliary form of annular granuloma, paratuberculous dermatosis or as an independent disease.

[ 1 ], [ 2 ]

Causes shiny shingles

The causes and pathogenesis of lichen spicata have not been fully established. Most authors believe that the dermatosis is a kind of lichenoid tissue reaction to various exogenous and endogenous irritants.

[ 3 ], [ 4 ], [ 5 ]

Pathogenesis

The histological picture is characterized by perivascular granulomas consisting of epithelioid cells, lymphocytes, histiocytes, and a few giant cells.

Pathomorphology of lichen planus

In the upper third of the dermis, in the area of the papular element, there is a dense infiltrate, closely adjacent to the epidermis, consisting of lymphocytes, histiocytes and epithelioid cells, among which giant Pirogov-Langhans cells are sometimes found. The epidermis is somewhat flattened with smoothed epidermal outgrowths. However, along the edges of the infiltrate, the epidermal outgrowths are sometimes elongated and embrace it in the form of "pincers", which is a pathognomonic sign for this disease and distinguishes it from lichen planus. In cases of the perforating form of lichen planus, the epidermis shows signs of vacuolar dystrophy of cells, accompanied by exocytosis.

Histogenesis is unclear. In the pathogenesis of the disease, the allergic component is considered important, in particular, vascular lesion of an allergic nature. Th. Naseman (I980), based on the similarity of the histological picture in lichen scaly and sarcoidosis, suggests that lichen scaly is a manifestation of an allergic reaction in sarcoidosis, but this point of view is not generally accepted.

[ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ]

Symptoms shiny shingles

It develops mainly in children and is clinically manifested by multiple, symmetrically located nodular rashes 1-2 mm in size, flat or hemispherical, with a shiny, usually non-flaky surface, sometimes with small depressions in the center, the color of normal skin or pale pink. The outlines of the papules are round, less often - polygonal. The rashes are densely located, sometimes - annular, most often on the skin of the penis, but can also be generalized. Atypical psoriasiform, eczema-like, hemorrhagic, vesicular, perforating forms of the disease have been described. Damage to the palms and soles, nail plates, oral mucosa, a combination with typical manifestations of lichen planus, fusion of rashes into small plaques, a positive isomorphic Koebner reaction can be observed.

The disease is more common in children. The primary element is isolated flat papules 1-2 mm in diameter with a shiny, non-flaky surface, with clear boundaries, having rounded outlines, flesh-colored or pale pink or normal skin color. Most often, the rash is located in the area of the knee and elbow joints, on the skin of the penis. Rarely, the rash has a generalized nature and can be localized on the mucous membranes. Palms, soles and nails may be affected. Subjective sensations are usually absent. The course of the dermatosis can be long-term.

Differential diagnosis

Lichen scaly should be differentiated from lichen planus, lichenoid tuberculosis, lichenoid syphilides, lichen awl-shaped, and follicular mucinosis.

[ 12 ], [ 13 ], [ 14 ], [ 15 ]

Treatment shiny shingles

General tonics are recommended (vitamins A, C, D, group B, fish oil, biogenic stimulants, etc.). Of the external agents, 1-2% salicylic-sulfur, salicylic-resorcinol pastes and ointments with the addition of 0.05% retinoic acid and hormonal creams and ointments are used. The effectiveness of treatment increases with ultraviolet irradiation. In severe forms, small doses of glucocorticosteroids are prescribed.