Frictional Lichenoid Dermatitis is an rarely diagnosed rash that occurs most commonly in children and is associated with either friction and/or atopy with a distinctive seasonal variation.
The disease occurs in childhood, with an average age of 9 years. The pathogenesis is unclear and may be due to friction, the atopic triad, UV radiation, or a combination of the three. Although UV radiation has not been shown to cause papular eruptions in studies, there is some degree of photosensitivity.
The rash is typically described as flesh-colored or slightly erythematous, flat-topped papules 1-2 mm in diameter on the extensor surfaces of the elbows and knees. Mild scaling and excoriation may be present. Resolution may be associated with hypopigmentation. In most cases, the presence of pruritus is complained of.
Diagnosis is based on the characteristic clinical presentation, history of atopy, or UV exposure.
- Psoriasis
- Papular or follicular atopic eczema
- Keratosis pilaris
- Gianotti-crosti syndrome
- Dermatomyositis
- Flat warts
- Molluscum contagiosum
Frictional lichenoid dermatitis is a benign and self-limiting disease that can spontaneously resolve after weeks to months.
Treatment may include:- Low potency topical corticosteroids
- Hydrocortisone acetate cream 2 times a day for 7-10 days or
- Desonide cream 2 times a day for 7-10 days or
- Fluticasone propionate 2 times a day for 7-10 days.
- Moistuzers
- 6-12% lactic acid 1/day for 2-3 weeks