An illustrative case report and a series of 18 welldocumented cases of lichen striatus are presented. It is most often found on the arms or legs, but can also happen on the face, neck or body. However, only one case of lichen striatus was observed which a female patient was 4. An interesting case of lichen striatus occurring in a 56. Of particular interest is the ultrastructure of the dyskeratotic cell in this condition and its similarity to the corps rond cell of dariers disease. In 1990, grosshans and marot introduced the term adult blaschkitis ab, describing an eruption similar to ls occurring in an adult adult ls. Histopathology shows lichenoid reaction involving follicles and glands. There are reported cases of blaschkitis occurring in children and lichen striatus occurring in adults. Lichen striatus with nail dystrophy jama dermatology jama. Lichen striatus ls is a benign, uncommon, selflimited, linear inflammatory skin disorder that primarily affects. Lichen striatus is a rare, benign, selflimited linear dermatosis of unknown origin that predominantly affects children.
Histopathology findings indicate both lichenoid and spongiotic dermatitis. Lichen striatus is a relatively uncommon condition that typically affects children between ages 5 and 15 years 3,5. Hypopigmented skin lesions are frequent motive for consultation in the childhood. But despite some overlaping conditions, they can be easily differentiated. Lichen striatus is a skin condition that causes a rash that goes away on its own. This is a common and benign selflimited childhood dermatosis that is easily diagnosed from its classic appearance. Lichen striatus 0 0 1 100 1 lichen nitidus 0 0 0 0 0 seborrheic dermatitis 1 100 0 0 1 total 49 62. Lichen striatus ls is an uncommon, asymptomatic, selflimiting, linear dermatosis of unknown origin that usually occurs along blaschkos lines on the extremities. Lichen striatus clinical and histopathologic study with emphasis on vesicular aspects sigfrida. Lichen striatus ls is an uncommon, acquired, selflimited, and benign linear dermatosis of unknown etiology that most often occurs unilaterally and is confined to the lines of blaschko. Histology of lichen striatus shows lichenoid spongiotic dermatitis.
The rash of lichen striatus often affects a single arm or leg only but may also exist in the neck and torso. Blaschkolinear acquired inflammatory skin eruption, or blaschkitis. Participation of vascular, nervous, and lymphatic tissues has been suggested to explain. Lichen striatus is a selflimited, lichenoid eruption particularly common in children. The inflammatory cells push against the undersurface of the epidermis, which may be thinned and show overlying parakeratosis. They were diagnosed as lichen striatus based on clinical and histopathological findings. Lichen striatus is a not uncommon linear, selflimited skin eruption in children of unknown aetiology. However, we emphasize linear lichen planus as its main differential diagnosis. Participation of vascular, nervous, and lymphatic tissues has been suggestedto explainits linear quality,but actually we do. Participation of vascular, nervous, and lymphatic tissues has been suggested to explain its linear quality, but actually we do not know of any satisfactory reason for its distribution. Sep 26, 2016 lichen striatus is a benign and self limited rash that occurs in children anywhere from 5 to 15 years in 50 % of cases. When a linear eruption extends to the periungual area, nail changes, such as onycholysis, splitting, fraying, and loss of the nail plate, may result.
Lichen striatus is clinically diagnosed on the basis of its appearance and characteristic developmental pattern following the lines of blaschko. It can also occur on other parts of your childs body, such as his or her chest or face. Lichen striatus presents as as an erythematous papules which often join together to form a linear band following blaschko lines. Adult blaschkitis w lichen striatus w linear inflammatory dermatosis abstract background. It is characterized by a blaschko linear inflammatory papular eruption and is seen primarily in children 3,4. Unusual location of lichen striatus in an adult patient dergipark.
Lichen striatus ls is an uncommon dermatosis that generally affects children. We would like to report such a case, which was recently seen in our clinic. Some authors classify acquired blaschko dermatitis as the adult form of lichen striatus. Lichen striatus american osteopathic college of dermatology. Department of dermatology, qatif central hospital, kingdom of saudia arabia. However, my daughter was 2 years old when she suddenly had this rash appear on t. Several dermatological diseases are expressed by macules of whitish coloration and the lichen striatus is one of them. The resulting postinflammatory hypopigmentation can take a year or more to disappear. Lichen striatus is a rare skin condition that is seen primarily in children, most frequently appearing ages 515 22627 it consists of a selflimiting eruption of small, scaly papules. Lichen striatus is a benign, acquired, asymptomatic, selflimited tcell mediated dermatosis 1,2. Lichen striatus usually resolves within six months, although the lesions do not completely disappear. Lichen striatus is a selflimited linear rash appearing often on an extremity. Lymphohistiocytic infiltration superficially, sometimes.
There is no effective treatment for lichen striatus and in most cases none is necessary. Lichen striatus is a benign skin condition but can leave a temporary hypopigmentation or hyperpigmentation after it has resolved. Lichen striatus is a benign skin condition however can leave a temporary hypopigmentation or hyperpigmentation after it has actually fixed. Lichen striatus ls is a wellknown acquired linear inflammatory dermatosis. The histopathology of ls often shows a polymorphic epidermal reaction process of variable lichenoid and spongiotic changes having no specific histopathological criteria or simulating other diseases. A 31yearold man presented with a recurring pruritic rash on the right lateral flank and hip of 2 years duration.
Lichen striatus causes, pictures, pathology, treatment cure. Different from lichen planus that presents lichenoid infiltrate in stripe in the papillary dermis, the histopathology of lichen striatus shows focal lymphohistiocytic infiltrate and lichenoid, with deep and superficial adnexal involvement. The histology may closely mimic lichen nitidus or lichen planus even though the clinical features are those of lichen striatus. The incidence of lichen striatus is so rare that when such a condition occurs. Lichen striatus is diagnosed by its typical clinical appearance. The lesions are located on extremities and less commonly on the trunk, and they follow the developmental. The small papules, which may be smooth, scaly or flat topped are red, tan or the same color of the flesh. It rarely affects adults, and it is characterized by abrupt onset of coalescent papules, in a linear disposition. Very few cases of bilateral ls have been previously reported in the. Findings on histopathology of a skin biopsy may also be helpful. Lichen striatus is an idiopathic, selflimited, linear dermatosis that usually occurs in children or young adults. Lichen striatus is a more common condition and generally affects children with an average age of 3 years. The eruption is typically unilateral, most often involving the extremities, and follows the lines of blaschko in a continuous or interrupted pattern. Soeprono teaches and practices dermatopathology at loma linda university, school of medicine, department of dermatology.
In 1990, grosshans proposed that blaschkitis was distinct from lichen striatus, identifying several criteria by which the 2 differ, including typical patient age, distribution, time course, and histopathology. Clinical and laboratory features of 115 children to. Blaschkolinear acquired inflammatory skin eruption, or. Histopathology confirmed the clinical diagnosis of lichen striatus. We also did kappa analysis and found that in lichen planus there was a fair clinicopathological correlation with 0. It is most often found on the arms or legs, but can also happen on the face, neck or. It is reported here the case of an adult woman with erythematous violaceous papules on the left leg, diagnosed with lichen striatus by clinical and histopathological. It looks like a collection of small bumps or flat spots that run up and down a part of the body, usually in a straight or curved line. Lichen striatus is a rash that appears as pink or lightlycolored, scaly, flat bumps.
This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. The linearity has been shown to correspond in many cases to the pattern of blaschkos lines. Lichen striatus ls is an uncommon, acquired, selflimited, and benign. Lichenoid eruption an overview sciencedirect topics. Lichen striatus ls is a papulosquamous disorder with a distinctive linear distribution. Lichen striatus causes, pictures, pathology, treatment. Lichen striatus, however, primarily affects children, forming single lines along an extremity, and spontaneously resolves over months to years. Apoptosis dropping off of colloid bodies from the epidermis into the dermis occurs in disorders in which basal cell damage occurs, such as lichenoid. Mar 26, 2020 lichen striatus is a rare, benign, selflimited linear dermatosis of unknown origin that predominantly affects children. On histopathology, lichen nitidus has a distinct, circumscribed infiltrate of lymphocytes, histiocytes, and giant cells in papillary dermis directly beneath a thinned epidermis. Similar to ls, histology shows hyperkeratosis, focal parakeratosis, and acanthosis of the epidermis. An histopathological and immunohistological study of forty. A healthy 7yearold girl presented to our clinic with bilateral asymmetric ls occurring on the right arm and left leg of 1year duration. Furthermore, lichen striatus following blaschko lines.
The rash of lichen striatus frequently impacts a single arm or leg only but may also exist in the neck and torso. The eruption normally grows over a few days to weeks. Lichen striatus may also show spongiosis in addition to lichenoid and periadnexal inflammation. Ls can usually be identified by clinical history and histology of typical lesions. Lichen striatus ls is a benign, uncommon, selflimited, linear inflammatory skin disorder that primarily affects children up to 15 years of age, most commonly around 2 to 3 years of age, and is seen more frequently in girls. Sometimes the rash can appear inflamed or redder, with a thicker scale. Lichen striatus is a unique line of pathologic reaction on the skin. Whereas the former clinical entity exhibits predominantly spongiotic changes on histopathology, lichen striatus displays lichenoid changes 3. Occasionally, there is overlap with linear lichen planus and blaschkitis, the main. Lichen striatus ls is a selflimiting, acquired linear inflammatory dermatosis that is seen primarily in children and is uncommon in adults. When it is found in conjunction with nail involvement, it is even rarer. Over time, these bumps come together to form a line or band on the skin. Tacrolimus has also been found out to be as effectiveas potent topical corticosteroidsand them to selfmedicate, which, in.
Between january 1989 and january 2000 we diagnosed lichen striatus in 37 boys and 78 girls mean age 4 years 5 months. It rarely affect adults, and is characterized byabrupt onset of pink, tan or hypopigmented small coalescent papules distributed in a linear configuration following blaschkos lines usually on the extremities or around the trunk, and on the face in 10% of cases. A 2yearold boy was seen in our clinic in march 1977. Lichen striatus has been reported following bcg vaccination, 434 varicella infection, 442 solarium exposure, 443 and following a flulike illness. Lichen striatus is an uncommon inflammatory skin eruption of unknown etiology. Onset is usually between the ages of 3 and 10 years, and it is. Histopathological and immunohistochemical study of lichen. Soepronos textbook is available on and includes detailed information on over 600 entities and includes four dvd diskettes with highresolution images that provide a virtual dermatopathology reference and guide. Biopsy and histopathological analysis, when tolerable to the patient. The nomenclature of lichen striatus in adults has remained controversial. Jul 31, 20 dermatopathology reference describes lichen striatus histopathology including histologic features and provides links to additional medical references. Lichen striatus pictures, causes, treatment, symptoms. There are instances wherein the lesions will leave a temporary pale or dark marks. Lichen striatus presents as as an erythematous papules which often join together to form a linear band following blaschko lines histology of lichen striatus.
Lichen striatus is an acquired, asymptomatic, and selflimited linear inflammatory skin disorder that predominantly affects children. Others view it as a separate diagnosis given its distinctive histopathology as well as the fact that typical lichen striatus cases are encountered in adults. Lichen nitidus consists of small, glistening, monomorphic, fleshcolored to pink or reddishbrown papules of unknown etiology. This process has no specific histopathological criteria because microscopic findings change with the age of the lesion. Lichen striatus is a fairly common, self limited, unilateral single sided eruption with a linear shape. In individuals with darker skin tones, lichen striatus may not be noticeable until the appearance of a resolving band of hypopigmentation. Verrucous coalescing dry papules and plaques on the hip. Departments of pathology, bahrain defence force hospital and royal college of surgeons in ireland kingdom of bahrain. Lichen striatus definition of lichen striatus by medical. Topical corticosteroid cream therapy was started to. In lichen striatus, sections show a lichenoid infiltrate involving an epidermis which is usually acanthotic figure 1. Lichen striatus, journal of cutaneous pathology 10. Feb 26, 2019 lichen striatus ls, also known as blaschko linear acquired inflammatory skin eruption, or linear lichenoid dermatosis, is a benign, rare and selflimiting inflammatory skin condition. It is characterized by 1 to 3mm smooth or scaly papules that coalesce in linear array usually on one extremity, occasionally extending to the trunk or nails.
Lichen striatus is a condition that causes a long streak or band of flesh colored or red bumps to form on your childs skin. The light microscopic and ultrastructural characteristics of lichen striatus are discussed. Pdf lichen striatus is a wellknown, acquired, selfhealing, linear inflammatory. A lichen striatus can lead to dryness and itching of the skin. A papule of lichen nitidus shows a dense, wellcircumscribed, subepidermal infiltrate, sharply limited to one or two adjacent dermal papillae. Histological, immunohistochemical, and ultrastructural study of 37 cases. Apr 04, 2018 lichen planus is a skin rash triggered by the immune system. We studied their family history and the season of onset, morphology, distribution, extent, duration, histopathology, and treatment of their lichen striatus. Lichen striatus ls is an uncommon dermatosis of unknown etiology that presents as a continuous or interrupted linear band of pink, tan, red or skincolored papules in a blaschkoid distribution. On histology, blaschkitis features spongiotic dermatitis.
There may be several contributing factors, and each case is different. Lichen striatus is a rare, selflimiting lichenoid eruption of unknown etiology. Lichen striatus, my daughters story knoxville pediatric. The mean age at diagnosis was 3 years 6 months to 14 years. Lichen striatus, however, primarily affects children, forming single lines along an. We have also observed a few interesting cases of zosteriform, blaschkoid, and linear lichen planus. A diagnosis was made on the basis of typical clinical features and confirmed by histopathology of the skin and nail matrix.