Lichen Planus in the Lines of Blaschko

Abstract

We describe three adolescents with eruptive linear lesions of the back, abdomen, and extremities distributed along the lines of Blaschko. Clinically one of these lesions resembled an epidermal nevus in its morphology and distribution. A biopsy specimen demonstrated the typical histology of lichen planus (LP). There have been fewer than 20 reported cases of childhood linear LP. Our patients demonstrate that linear LP sometimes may closely resemble an epidermal nevus and may auger the onset of more generalized LP or more involvement along the lines of Blaschko, that is, "Blaschkoian" disease. Previous studies have referred to this variant as zosteriform. Our cases are the fourth, fifth, and sixth cases of childhood LP reported to occur along the lines of Blaschko. Based on the clinical findings in our patients and a review of the English-language literature, we believe that linear LP is usually distributed along the lines of Blaschko and should be renamed lichen planus, Blaschko subtype.

Bilateral linear lichen planus along the lines of Blaschko: Report of a rare case and brief review

“…Some of the reported "zosteriform" LP cases need to be revised as Blaschkoid LP [4,8]. To solve this controversy, Blaschko lines should be clearly distinguished from other linear patterns such as lines of innervation of spinal nerves (dermatomes), Langer's lines, etc.…”

“…Linear LP has been described in less than 1% of all LP patients [3]. Almost all of the reported cases of linear lichen planus along the lines of Blaschko presented unilaterally [3][4][5][8][9][10]. We herein report a rare case of bilateral linear Blaschkoid lichen planus.…”

“…following the course of a peripheral nerve) either de novo or at the sites of trauma (isomorphic response or Koebnerization) [2] or as Wolf's isotopic response at the site of healed herpes zoster [3]. In addition, linear LP may present with development of lesions along the lines of Blaschko [3,4]. Blaschko's lines do not correspond to the nervous, vascular or lymphatic structures and represent a form of mosaicism that develops during the embryonic period [5].…”

Líquen Estriado Seguido de Líquen Plano Clássico: Estados dum Espectro de Doença?

“…The differential diagnosis of LLP includes other dermatoses following the Blaschko lines such as lichen striatus and linear lichen nitidus. 2,3 On the other hand, lichen striatus (LS) is an asymptomatic dermatosis that generally occurs in childhood. It consists of small, scaly, erythematous papules distributed in a linear band along the Blaschko lines, usually unilaterally distributed on a limb.…”

Zosteriform Lichen Planus: case report of a rare variant of Lichen Planus

“…Linear distribution of the disease has been described in less than 1% of patients and need to be differentiated from other linear dermatoses [1]. It may be zosteriform and follows the lines of Blaschko [2,3]. We report a rare case of Zosteriform variant of Lichen planus in a young patient.…”