Lichen nitidus of the palms: A case with peculiar histopathologic features

Palmar involvement in lichen nitidus is infrequent. In such cases, the hist opathologic findings of palmar lesions are usually identical to those of ex trapalmar ones. We report on the case of a patient with multiple tiny papul es located on the palms and elbows. A biopsy specimen from the elbow showed the typical features of lichen nitidus, but a biopsy from the palm disclos ed an inflammatory infiltrate mostly disposed around the bases of rete ridg es and composed of lymphocytes and histiocytes with some giant cells both i n the dermis and in the epidermis. This location of the infiltrate is simil ar to that found in hypertrophic lichen planus, a combination of lichen pla nus and lichen simplex chronicus. We conclude that this histopathologic fea ture in palmar lichen nitidus could be the result of the superimposition of lichen nitidus on normal palmar skin, resulting in a picture resembling hy pertrophic lichen planus.