Image of the Month: Answer

This 10-year-old boy has lichen nitidus (Fig. 1).

Lichen nitidus is a chronic inflammatory dermatosis characterised by minute, shiny, flat-topped, pale, exquisitely discrete, uniform papules. The individual papules are rarely larger than the size of a pinhead. Linear arrays of papules are often seen on areas exposed to scratching (Koebner's phenomenon). The lesions may be limited to the distal forearms, trunk, lower abdomen and inner thighs or may later become generalised. Lichen nitidus is generally asymptomatic, and treatment is generally not necessary. Topical corticosteroid application may lead to early resolution of the skin lesions.