0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Pathological Case of the Month FREE

[+] Author Affiliations

Section Editor: Enid Gilbert-barness, MD

More Author Information
Arch Pediatr Adolesc Med. 2001;155(2):198. doi:10.1001/archpedi.155.2.197.
Text Size: A A A
Published online

Figure 1. Hypopigmented, flat-topped, scaly, lichenoid papules coalescing into a linear band on the right leg extending from the dorsum of the foot along the lateral aspect of the ankle.

Figure 2. Lesion extends up the lower leg to the mid thigh region.

Figure 3. A microscopic view of the lesion demonstrating spongiosis and exocytosis and a mononuclear, perivascular infiltrate in the superficial and deep dermis (hematoxylin-eosin, original magnification ×20).

Lichen striatus is an uncommon linear dermatosis of unknown origin that typically affects children between age 5 and 15 years and demonstrates a strong female predominance.1 Although it is rare in adults, lichen striatus can occur at any age. In addition, lichen striatus develops at a higher frequency in patients with a personal or family history of atopy.2 Most often, it begins with erythematous to flesh-colored, flat-topped, scaly papules that coalesce to form a continuous or interrupted band that is 1 to 3 cm in width. Lesions are typically solitary and unilateral and occur most frequently on the limbs and neck but can involve any region of the body. Occasionally, lesions may extend over the entire length of a limb and often are distributed along Blaschko lines (ie, the cutaneous lines of embryogenesis).3,4 Rare cases with multiple lesions distributed bilaterally have also been reported.5 When lichen striatus involves the nails, longitudinal ridging, splitting, fraying, onycholysis, and even total nail loss may occur.6

The onset of lesions in lichen striatus is usually sudden, with the eruption progressing to its fully developed form over days to weeks. Though typically asymptomatic, lesions may be associated with pruritus. The condition is self-limited, and lesions undergo spontaneous involution, typically disappearing within 1 year. Lesions resolve without scarring; however, a marked, transient postinflammatory hypopigmentation may be observed, especially in dark-skinned individuals.

The clinical differential diagnosis of lichen striatus includes linear forms of other lichenoid eruptions, including lichen planus, lichen nitidus, and lichen simplex chronicus as well as linear epidermal nevus, linear psoriasis, linear porokeratosis, tinea corporis, and verruca plana. Though lichen striatus usually resolves within a year of onset, occasionally lesions may persist for longer periods of time. In these cases, skin biopsy findings can differentiate lichen striatus from other entities such as linear epidermal nevi. Linear epidermal nevi, unlike lichen striatus, may be associated with underlying musculoskeletal, nervous, ocular, and cardiovascular anomalies and carry the potential for malignant transformation. Histopathologic features in lichen striatus include a mononuclear superficial and deep perivascular dermal infiltrate. The epidermis may demonstrate intracellular and extracellular edema with some exocytosis and parakeratosis.

Because of its benign, transitory course, treatment for lichen striatus is not indicated unless lesions are associated with considerable pruritus or pose a cosmetic concern. In these cases, a trial of topical steroids may shorten the duration of lesions.7

Accepted for publication November 24, 1999.

Reprints: Bernard A. Cohen, MD, Division of Pediatric Dermatology, Johns Hopkins Hospital, Brady 208, 600 N Wolfe St, Baltimore, MD 21287.

Staricco  RG Lichen striatus. Arch Dermatol. 1959;79311- 324
Link to Article
Toda  KOkamoto  HHorio  T Lichen striatus. Int J Dermatol. 1986;25584- 585
Link to Article
Taieb  AEl Youbi  AGrosshans  EMaleville  J Lichen striatus: a Blaschko linear acquired inflammatory skin eruption. J Am Acad Dermatol. 1991;25637- 642
Link to Article
Bolognia  JLOrlow  SJGlick  SA Lines of Blaschko. J Am Acad Dermatol. 1994;31157- 190
Link to Article
Mopper  CHorwitz  DC Bilateral lichen striatus. Cutis. 1971;8140
Karp  DLCohen  BA Onychodystrophy in lichen striatus. Pediatr Dermatol. 1993;10359
Link to Article
Hurwitz  S Clinical Pediatric Dermatology.  Philadelphia, Pa WB Saunders Co1993;55- 56

Tables

References

Staricco  RG Lichen striatus. Arch Dermatol. 1959;79311- 324
Link to Article
Toda  KOkamoto  HHorio  T Lichen striatus. Int J Dermatol. 1986;25584- 585
Link to Article
Taieb  AEl Youbi  AGrosshans  EMaleville  J Lichen striatus: a Blaschko linear acquired inflammatory skin eruption. J Am Acad Dermatol. 1991;25637- 642
Link to Article
Bolognia  JLOrlow  SJGlick  SA Lines of Blaschko. J Am Acad Dermatol. 1994;31157- 190
Link to Article
Mopper  CHorwitz  DC Bilateral lichen striatus. Cutis. 1971;8140
Karp  DLCohen  BA Onychodystrophy in lichen striatus. Pediatr Dermatol. 1993;10359
Link to Article
Hurwitz  S Clinical Pediatric Dermatology.  Philadelphia, Pa WB Saunders Co1993;55- 56

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Related Collections
PubMed Articles