Lichen nitidus is a well-recognized dermatosis composed of minute, dome-shaped papules having a characteristic tuberculoid histology. Microscopically there is flattening of the epidermis with some lengthening of the rete pegs at the margin of the lesion, and close beneath the epidermis is an infiltrate consisting of round cells, epithelioid cells, and occasional Langhans' giant cells (Fig. 1). Pinkus (1907), in his original paper, described the formation of actual tubercles, but Lever (1954) states that tubercles are never formed; Ormsby and Montgomery (1954) accept a tuberculoid infiltrate without actual symmetrical arrangement of the cells into a tubercle. In contrast to lichen nitidus, lichen planus shows a monomorphic infiltrate consisting principally of lymphocytes lying close beneath the epidermis and having a well-defined lower border (Fig. 2).
These 2 types of lesions have, however, been described from time to time in the same patient (Civatte, 1911; Lewis, 1937; Wilson, 1949), and Civatte (1927)
WILSON HTH, BETT DCG. Miliary Lesions in Lichen Planus. Arch Dermatol. 1961;83(6):920–923. doi:10.1001/archderm.1961.01580120032006
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