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Case of the Month

Leg before treatment
Face After Treatment

This 11-year-old-girl developed an eruptive, cram-colored, papular rash on her face after playing 2 days in an a weekend soccer tournament on consecutive, hot, sunny, no-clouds-in-the-sky days.

What's Your Diagnosis?


Diagnosis: Actinic Lichen Nitidus

Discussion

I was preparing a talk and came across this case yesterday. I thought I'd nominate this for the “case-of-the-month” since this is the time of the year we start seeing actinic lichen Nitidus in kids who spend lots of time in unprotected sun. This 11-year-old-girl developed an eruptive, papular rash on her face after playing 2 days in an a weekend soccer tournament on consecutive, hot, sunny, no-clouds-in-the-sky days.

I treated it with a class VI steroid cream, BID x 2 weeks, then pulsed it on Wed/Sat for 2 weeks with pimecrolimus cream (Elidel) BID on the other days. Actinic Lichen Nitidus can be very difficult to treat and does not always respond. It is always so satisfying when it does respond and why I am so happy to present this successful case. The mom and patient were thrilled with the outcome and reported noticing good results at 2-3 weeks of treatment initiation. She was going to play all summer so I stressed the importance of proper sun protection. Once again, this was a nice result in a very tough-to-treat condition so I thought it was worth submitting. Thanks.

References

Actinic Lichen Nitidus


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Charles Crutchfield III M.D. Eagan Dermatologist

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