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Correspondence |

Lichen Spinulosus: Excellent Response to Tretinoin Gel and Hydroactive Adhesive Applications

Seth B. Forman, MD; E. Mac Hudgins, MD; W. Kenneth Blaylock, MD
Arch Dermatol. 2007;143(1):115-126. doi:10.1001/archderm.143.1.122.
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We report herein a case of lichen spinulosus (LS) treated safely and effectively with tretinoin gel and hydroactive adhesive applications. Lichen spinulosus is an uncommon cutaneous eruption characterized by grouped, thorny protrusions. Lichen spinulosus is commonly seen in patients with an atopic diathesis. Most of the patients described in the literature had a successful response to emollients, midpotency topical corticosteroids, and salicylic acid. These treatments are reported to be more effective under occlusion.1,2 Salicylic acid used under occlusion on the face in a pediatric patient may cause salicylism. The long-term use of midpotency topical corticosteroids under occlusion on the face is unacceptable. The combination of tretinoin gel, 0.04%, applied nightly and hydroactive adhesive applications daily will target LS both physiologically and mechanically. Therefore, we propose that tretinoin gel applied each night followed by hydroactive adhesive applications each morning is an effective, safe therapeutic option for the management of LS.

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Figure 2. Almost complete clearing after therapy with tretinoin gel and hydroactive adhesive applications.

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Figure 1. Concentrated patch of spiny, thornlike projections on the nose before therapy with tretinoin gel.

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