Lichen Striatus: Clinical and Laboratory Features of 115 Children

Abstract

To analyze the clinical features, response to treatment, and follow-up of lichen striatus and any associated symptoms or disease, we designed a retrospective study involving 115 affected children at the Pediatric Dermatology Unit of the Department of Dermatology of the University of Bologna, Bologna, Italy. Between January 1989 and January 2000 we diagnosed lichen striatus in 37 boys and 78 girls (mean age 4 years 5 months). We studied their family history and the season of onset, morphology, distribution, extent, duration, histopathology, and treatment of their lichen striatus. We found that family history was negative in all our patients except for two pairs of siblings. The majority of children had the disease in the cold seasons; precipitating factors were found in only five cases. The most frequently involved sites were the limbs, with no substantial difference between upper and lower limb involvement. When lichen striatus was located on the trunk and face, it always followed Blaschko lines; in seven children the bands on the limbs appeared to be along the axial lines of Sherrington. In 70 cases, lichen striatus was associated with atopy. The mean duration of the disease was 6 months and relapses were observed in five children, and in one instance the disease had a prolonged course. Only a few case study series of lichen striatus in children have been reported and ours is the largest to date. The etiology of lichen striatus remains unknown in the majority of our patients. The confirmed association with atopy observed in our patients may be a predisposing factor. It has generally been accepted that lichen striatus follows the lines of Blaschko, and this distribution is a sign of both a topographic and a pathogenetic concept. In patients where lichen striatus is along axial lines, a locus minoris resistentiae, we suppose that this distribution may only be an illusory phenomenon in instances in which the trigger factor prefers this route, consisting of several successive Blaschko lines, but appearing as a single band.

Cryotherapy for Lichen Striatus in an Adult – a Case Report

“…Regarding aberrant cell-mediated immune mechanism acting as an endogenous triggering event in unmasking aberrant clones, this hypothesis could be substantiated by the higher association of atopy with LS reported by some authors (11). However, Taniguchi et all., have found an association between LS and personal history of atopy, which closely approaches the incidence of atopy in the general population (12).…”

The toddler with 1 striped leg: a linear papular rash

“…3 Occasionally, patients have hypopigmented macules and papules (classified lichen striatus albus) or involvement of the nails. 3 Lichen striatus typically occurs on only 1 side of the body and affects the limbs. It can, however, occur bilaterally and on the trunk or face.…”

“…1,4 In most cases, the distribution of the papules tends to follow the Blaschko lines, which are thought to correspond to the migration of embryonic skin cells. 3 Although most patients have no symptoms other than the rash, some experience itchiness of the affected skin. 1 The cause of lichen striatus is unknown.…”

“…They should be counselled to expect temporary hyper-or hypopigmentation of the affected skin after resolution of the papules. 2,3 If lichen striatus does not resolve spontaneously within 3-12 months, the clinician should re-evaluate the diagnosis, being careful to rule out linear lichen planus and scleroderma. The mean duration of the disease is 6 months.…”

“…The mean duration of the disease is 6 months. 3 If the patient's nails are affected, complete resolution of nail deformities can take up to 30 months. Some physicians have attempted to treat lichen striatus using topical corticosteroids.…”