Pediatric emergency medicine trisk 1816 1816

Lichen Nitidus
Lichen nitidus is characterized by tiny, pinpoint, flat-topped, skin-colored papules
( Fig. 88.12 ). The papules are often grouped and are found in scratch lines (i.e.,
the Koebner phenomenon). Although any skin surface may be involved, the trunk
and genitalia are common sites. The lesions are often asymptomatic but may
occasionally itch. The lesions persist for variable periods and generally do not
respond to therapy.

PLAQUES
Annular Plaques
Granuloma Annulare
Granuloma annulare is believed to be an idiosyncratic response to trauma and
looks to many like tinea corporis (“ringworm”) without the scale. This skin
change may begin as a skin-colored or violaceous papule that clears centrally as
the margins advance, or it may appear as a group of papules arranged in a ringlike configuration ( Fig. 88.13 ). The central portion of the lesion is often dusky
or hyperpigmented. The key point on physical examination is the lack of scaling.
This physical finding distinguishes granuloma annulare from tinea corporis. The
border is firm on palpation, unlike tinea corporis. The rings can be 5 cm in
diameter or larger.

FIGURE 88.11 Lichen striatus.