Lichen striatus

	WikiDoc Resources for Lichen striatus
Articles
Most recent articles on Lichen striatus Most cited articles on Lichen striatus Review articles on Lichen striatus Articles on Lichen striatus in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Lichen striatus Images of Lichen striatus Photos of Lichen striatus Podcasts & MP3s on Lichen striatus Videos on Lichen striatus
Evidence Based Medicine
Cochrane Collaboration on Lichen striatus Bandolier on Lichen striatus TRIP on Lichen striatus
Clinical Trials
Ongoing Trials on Lichen striatus at Clinical Trials.gov Trial results on Lichen striatus Clinical Trials on Lichen striatus at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Lichen striatus NICE Guidance on Lichen striatus NHS PRODIGY Guidance FDA on Lichen striatus CDC on Lichen striatus
Books
Books on Lichen striatus
News
Lichen striatus in the news Be alerted to news on Lichen striatus News trends on Lichen striatus
Commentary
Blogs on Lichen striatus
Definitions
Definitions of Lichen striatus
Patient Resources / Community
Patient resources on Lichen striatus Discussion groups on Lichen striatus Patient Handouts on Lichen striatus Directions to Hospitals Treating Lichen striatus Risk calculators and risk factors for Lichen striatus
Healthcare Provider Resources
Symptoms of Lichen striatus Causes & Risk Factors for Lichen striatus Diagnostic studies for Lichen striatus Treatment of Lichen striatus
Continuing Medical Education (CME)
CME Programs on Lichen striatus
International
Lichen striatus en Espanol Lichen striatus en Francais
Business
Lichen striatus in the Marketplace Patents on Lichen striatus
Experimental / Informatics
List of terms related to Lichen striatus

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2] Kiran Singh, M.D. [3]

Synonyms and keywords: Linear lichenoid dermatosis

Overview

Lichens striatus (LS) is an acquired, self-limiting inflammatory dermatosis that follows the lines of Blaschko.

Pathophysiology

Blaschko lines have an embryologic origin and correspond to the direction of growth of the cutaneous cells, resulting in a cutaneous mosaicism. The genetic mosaicism could be responsible for cutaneous antigenic mosaicism, the expression of which might be induced by various external factors. Lichen striatus has been considered to be the consequence of an acquired stimulus that induces a loss of immunotolerance to embryologically abnormal clones, resulting in a T-cell-mediated inflammatory reaction.^[1]

Causes

The etiology of the eruption is unknown. Several theories suggest a genetic predispostion with the following acting as possible triggers.^[1]

Hypersensitivity
Cutaneous injury
Viral infection
Environmental factors
Immunization^[2]^[3]
Pregnancy^[4]

Differentiating Lichen Striatus from other Conditions

Lichen planus

Epidemiology and Demographics

Lichen striatus is a rare skin condition that is seen primarily in children, most frequently appearing ages 5–15.^[5] It consists of a self-limiting eruption of small, scaly papules.^[6]

Natural History, Prognosis and Complications

Lichen striatus has spontaneous remission, although the course of the disease is prolonged when nail involvement exists. Patients treated by a combination of topical retinoid with topical steroid have rapid resolution of lichen striatus and they not only achieve satisfying cosmesis, but also complete resolution of their pruritus. The most common side effect of the topical medication is localized irritation at treatment sites, but most of them would tolerate the treatment well.

Diagnosis

History and Symptoms

Lichen striatus presents as an eruption characterized by sudden onset of flat-topped, 1 to 4 mm, pink, tan, or hypopigmented papules in a linear configuration or Blaschkoid distribution. It may be associated with some irritation and soreness in the muscles of the affected parts.

Physical Examination

Skin

Trunk

Lichen striatus. Adapted from Dermatology Atlas.^[7]

Extremity

Lichen striatus. Adapted from Dermatology Atlas.^[7]
Lichen striatus. Adapted from Dermatology Atlas.^[7]
Lichen striatus. Adapted from Dermatology Atlas.^[7]
Lichen striatus. Adapted from Dermatology Atlas.^[7]
Lichen striatus. Adapted from Dermatology Atlas.^[7]
Lichen striatus. Adapted from Dermatology Atlas.^[7]

Laboratory Findings

Histopathologic examination of papules would reveal the presence of a lichenoid, lymphocytic infiltration and scattered melanin incontinence in the papillary dermis with epidermal hyperkeratosis, exocytosis of lymphocytes and necrotic keratinocytes.

Treatment

The condition is benign and no need for biopsy. Studies have showed monitoring without biopsy is a reasonable approach to the management of uncomplicated lichen striatus, particularly when the face is involved. However topical medications would produce rapid resolution. The following are currently used medications :

Topical retinoids
Topical steroids
Tacrolimus, especially for facial lesions^[8]
Photodynamic theraphy^[9]

References

↑ ^1.0 ^1.1 Patrizi A, Neri I, Fiorentini C, Bonci A, Ricci G (2004). "Lichen striatus: clinical and laboratory features of 115 children". Pediatr Dermatol. 21 (3): 197–204. doi:10.1111/j.0736-8046.2004.21302.x. PMID 15165195.
↑ Karakaş M, Durdu M, Uzun S, Karakaş P, Tuncer I, Cevlik F (2005). "Lichen striatus following HBV vaccination". J Dermatol. 32 (6): 506–8. PMID 16043931.
↑ Hwang SM, Ahn SK, Lee SH, Choi EH (1996). "Lichen striatus following BCG vaccination". Clin Exp Dermatol. 21 (5): 393–4. PMID 9136170.
↑ Brennand S, Khan S, Chong AH (2005). "Lichen striatus in a pregnant woman". Australas J Dermatol. 46 (3): 184–6. doi:10.1111/j.1440-0960.2005.00176.x. PMID 16008653.
↑ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
↑ James, William D.; Berger, Timothy G.; Elston, Dirk M. (2011). Andrews' Diseases of the Skin: Clinical Dermatology (11th ed.). London: Elsevier. pp. 223–224. ISBN 9781437703146.
↑ ^7.0 ^7.1 ^7.2 ^7.3 ^7.4 ^7.5 ^7.6 "Dermatology Atlas".
↑ Fujimoto N, Tajima S, Ishibashi A (2003). "Facial lichen striatus: successful treatment with tacrolimus ointment". Br J Dermatol. 148 (3): 587–90. PMID 12653755.
↑ Park JY, Kim YC (2012). "Lichen striatus successfully treated with photodynamic therapy". Clin Exp Dermatol. 37 (5): 570–2. doi:10.1111/j.1365-2230.2011.04284.x. PMID 22300391.

Template:WikiDoc Sources

[pmid15165195-1] 1.0 ^1.1 Patrizi A, Neri I, Fiorentini C, Bonci A, Ricci G (2004). "Lichen striatus: clinical and laboratory features of 115 children". Pediatr Dermatol. 21 (3): 197–204. doi:10.1111/j.0736-8046.2004.21302.x. PMID 15165195.

[pmid16043931-2] Karakaş M, Durdu M, Uzun S, Karakaş P, Tuncer I, Cevlik F (2005). "Lichen striatus following HBV vaccination". J Dermatol. 32 (6): 506–8. PMID 16043931.

[pmid9136170-3] Hwang SM, Ahn SK, Lee SH, Choi EH (1996). "Lichen striatus following BCG vaccination". Clin Exp Dermatol. 21 (5): 393–4. PMID 9136170.

[pmid16008653-4] Brennand S, Khan S, Chong AH (2005). "Lichen striatus in a pregnant woman". Australas J Dermatol. 46 (3): 184–6. doi:10.1111/j.1440-0960.2005.00176.x. PMID 16008653.

[Andrews-5] James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.

[Andrews_new_ed-6] James, William D.; Berger, Timothy G.; Elston, Dirk M. (2011). Andrews' Diseases of the Skin: Clinical Dermatology (11th ed.). London: Elsevier. pp. 223–224. ISBN 9781437703146.

[Dermatology_Atlas-7] 7.0 ^7.1 ^7.2 ^7.3 ^7.4 ^7.5 ^7.6 "Dermatology Atlas".

[pmid12653755-8] Fujimoto N, Tajima S, Ishibashi A (2003). "Facial lichen striatus: successful treatment with tacrolimus ointment". Br J Dermatol. 148 (3): 587–90. PMID 12653755.

[pmid22300391-9] Park JY, Kim YC (2012). "Lichen striatus successfully treated with photodynamic therapy". Clin Exp Dermatol. 37 (5): 570–2. doi:10.1111/j.1365-2230.2011.04284.x. PMID 22300391.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]