Wickham striae on skin appendages: a helpful dermoscopic feature

Abstract

Lichen planus (LP) is a chronic inflammatory disease, clinically characterized by purpuric, itchy papules that typically spread on the trunk and extremities. Other body sites can also be affected, including mucosal membranes, nails, and the scalp. The use of dermoscopy is essential in determining the diagnosis of LP, as it may highlight pathognomonic features such as Wickham striae (WS). WS are thin, pearly white structures arranged in a reticular pattern that are observed over LP lesions and histologically correspond to epidermal hypergranulosis. WS is usually most visible on the oral mucosa but can also cover almost every active LP papule. Here, we report two cases of biopsy-proven LP that show WS on dermoscopy in two specific sites: the scalp and proximal nail fold.

Dermoscopic Nail Changes in Psoriasis, Lichen Planus, and Lichen Striatus

“…In some patients, flattened papules with dermoscopically visible Wickham striae may be seen and may be helpful for diagnosis [40]. Ragged cuticle was observed in 33.4% of nails [28].…”

Lichen planus: A Systematic Review

“…On close inspection, a Wickham's striae network is visible 6 , and the lesions may follow a linear arrangement (Koebner phenomenon). 7 The eruptions are typically located on the lower back, wrists, forearms, and ankles of the lower limbs. Lichen planus can also affect mucous membranes (oral cavity, esophagus, genital organs), the hairy skin of the scalp, and nail plates.…”