LICHEN STRIATUS

By Gary M. White, MD

Lichen striatus


Lichen striatus is a linear inflammatory condition that typically affects young children. See also lichen striatus in adults.

Clinical

Linear papules or red, scaly lesions which appear suddenly in a child and follow Blaschko's lines are characteristic. It may occur at any age and may affect nearly any body site, including the face. Post inflammatory hypopigmentation is common. Some patients who present late may just have linear hypopigmentation.

Blaschkitis

The term "blaschkitis" was coined to describe an acquired linear inflammatory dermatosis following Blaschko's lines in an adult patient. The similarities to LS are many and it has been argued that Blaschkitis and LS represent the same entity. Of note, some patient have been reported having histological features of both a lichenoid dermatitis and spongiotic dermatitis [Indian J Dermatol 2016;61:348]

Treatment

No specific treatment is known effective. Lichen striatus usually involutes within a year. IL steroids may be tried to limited areas if persistent. Nail matrix lichen striatus resolves in 1-2 years.  Tacrolimus 0.1% cleared a woman's LS after 4 weeks.   Acitretin 0.5 mg/kg/day completely cleared one woman's LS after 4 weeks of therapy [Indian Dermatol Online J. 2014 Oct-Dec; 5(4): 501–503].

For any residual hypopigmentation, the 308-nm excimer laser completely repigmented over 90% of patients in one retrospective study [JAAD 2016;75;637].

Additional Pictures

Lichen striatus Lichen striatus

Lichen striatus Lichen striatus Lichen striatus Lichen striatus

Lichen Striatus affecting the nail of a young child (duration 6 months.)
Lichen striatus of the nail

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