Condyloma with lichen nitidus.Skinmed. 2005 May-Jun;4(3):177-8.

A 32-year-old black man presented with two separate eruptions on his penis (Figure). He has had a 10-year history of asymptomatic 1-3 mm shiny papules on the shaft of his penis. He also has had one asymptomatic verrucous brown plaque 1.5 cm in diameter on his penis. A small shave biopsy was performed for each process. The former showed lymphocytes and histocytes in the papillary dermis in a "ball-in-claw" relation to the rete ridges of the epidermis. The latter showed an acanthotic epidermis with papillomatosis. Diagnoses of lichen nitidus and condyloma acuminata were respectively made. As the shiny papules did not bother the patient, but he wanted to be rid of the verrucous plaque, only the latter was treated. Liquid nitrogen was applied to the plaque. The patient was also given podofilox 0.5% gel to apply to the condyloma overnight on Monday, Tuesday, and Wednesday, with a 4-day respite. This cycle was to be repeated for 3 more weeks. He was examined several more times and treated with cryotherapy and podofilox gel with the near disappearance of the condyloma over 4 months.

Generalized lichen nitidus.Pediatr Dermatol. 2005 Mar-Apr;22(2):158-60.

Lichen nitidus is a rare chronic condition of unknown etiology. Generalized lichen nitidus is even rarer. We report here a 5-year-old girl who had multiple, asymptomatic, discrete, 1 to 2 mm flesh-colored, shiny, flat, papules on her face, upper limbs, and thighs with relative sparing of the trunk. Resolution of these papular lesions was followed by hyperpigmented macules in those areas. Histopathologic examination of a papular lesion revealed a localized granulomatous lymphohistiocytic infiltrate in an expanded dermal papilla with thinning of overlying epidermis and downward extension of the rete ridges at the lateral margin of the infiltrate, producing a typical "claw clutching a ball" picture, confirming our clinical diagnosis of lichen nitidus. The pigmented macules showed melanin pigmentation on histology. There was no response to oral astemizole treatment for 3 months. However, the lichen nitidus lesions resolved spontaneously without any further treatment over the next year, leaving behind a prominent pigmentary disturbance.