A case of lichen striatus complicated by calcinosis cutis and epidermoid cyst

Abstract

A 14-year-old female patient presented with an 11-year history of linear pink flatted papules covered with a small quantity of scales on the inner side of her right lower limb.The lesions gradually enlarged.Five years prior to the presentation,indurated subcutaneous nodules arose in the papular lesions,and began to ulcerate with erythema,swelling,pain and an outflow of foreign bodies 10 days prior to the presentation.She had received no treatment before the presentation.On skin examination,linear atrophic dark erythematous patches were found on the inner side of the right lower limb and abdomen,under which some adhesive indurated nodules with tenderness and good mobility could be palpated.Some lesions were elevated with white,hard and massive material exuding from the ulcerated lesions.Histopathologically,the biopsy specimen from the right inner thigh showed epidermal hyperkeratosis,focal parakeratosis,focal liquifaction degeneration of basal cells,massive lymphocyte infiltration in superficial dermis,deep blue amorphous material in superficial and mid-dermis,which suggested a diagnosis of lichen striatus with calcinosis cutis;the biopsy specimen from the right inner leg showed focal epidermal hyperkeratosis,focal liquifaction degeneration of basal cells,patchy or massive lymphocyte infiltration around blood vessels and appendages in the papillary,mid and deep dermis,clumpy or fine calcium deposition in deep dermis and subcutaneous fat tissue,which were suggestive of lichen striatus,calcinosis cutis and epidermal cyst.Based on clinical findings and medical history,the diagnosis of lichen striatus,calcinosis cutis and epidermal cyst was made.The lesions were completely removed by 2 sessions of operation. Key words: Lichen striatus; Calcinosis; Epidermal cyst