Lichen Striatus Research Articles

Lichen striatus: a review.

Lichen striatus (LS) is an acquired blaschkitis, with typical linear and unilateral distribution. It occurs mainly in children and is self-resolving, yet its etiopathogenesis remains widely unknown. A review of the literature on LS cases was performed using the keyword "lichen striatus" to retrieve all relevant articles through PubMed and Google Scholar. A total of 27 articles describing 440 LS patients were included in the present review. Mean age of patients was 3.8 years; male: female: ratio was 1:1.9. The present review confirms LS as a primarily pediatric condition, mainly affecting females. Dysregulation of the immune system might be involved in its pathogenesis, with cytotoxic T-cells attacking mosaic keratinocytes after loss of immune tolerance. The review confirms LS is mainly diagnosed clinically (80%) based on its clinical characteristics: erythematous (70%) or hypopigmented (24%) papules, distributed along the lines of Blashko. The benignity of this clinical entity is suggested by the rather short duration of disease (9.5 months on average) and by the uncommonness of therapy, adopted in only 20% of cases, and when needed, administered topically. This review examines the complexities of LS but acknowledges limitations in data sources and calls for further research.

A Case of Lichen Striatus in an Adult Female

A Case of Lichen Striatus in an Adult Female

Tackling Inflammatory and Infectious Nail Disorders in Children.

Nail disorders are common in the pediatric population and affect quality of life. We review inflammatory conditions (ie, nail psoriasis, nail lichen planus [NLP], trachyonychia, nail lichen striatus, nail atopic dermatitis [AD]) as well as infectious conditions (ie, nail disease due to hand, foot, and mouth disease [HFMD] or Kawasaki disease, onychomycosis, acute paronychia). Inflammatory and infectious nail conditions may involve the skin or occur in isolation. By highlighting the distinctive features and clinical presentations of these infectious and inflammatory nail disorders in children, we aim to raise awareness among dermatologists to improve diagnosis and management.

Concurrence of Lichen Striatus in Siblings

Concurrence of Lichen Striatus in Siblings

Lichen Striatus with Nail Dystrophy in a 5-Year-Old Girl

Lichen Striatus with Nail Dystrophy in a 5-Year-Old Girl

Evaluation of linear dermatoses by reflectance confocal microscopy in children.

Lichen striatus (LS), linear psoriasis (LPs), linear cutaneous lupus erythematosus (LCLE) and linear lichen planus (LLP) often have similar clinical manifestations, which makes clinical diagnosis with the naked eye difficult; therefore, they are easily misdiagnosed. The purpose of this study was to determine whether reflectance confocal microscopy (RCM) is helpful in differentiating between these four linear dermatoses in children. This retrospective study included 14 patients with LS, nine with LPs, eight with LCLE and 12 with LLP. All patients were analysed using RCM, and biopsies were collected from lesions previously imaged by RCM. For LS, the dermal papillary rings were partially absent, but when present, manifested with small, homogeneously round, bright cells and occasionally highly refractive plump cellular structures, aggregated in clusters. LPs exhibited dark cyst-like structures with small, bright, round cells aggregated at the epidermal level; at the dermal-epidermal junction, homogeneously distributed, enlarged, faint dermal papillary rings and numerous enlarged low-refractive canalicular structures were observed in the superficial dermis. LCLE and LLP exhibited similar manifestations, including epidermal disarray, almost total absence of dermal papillary rings, and various sized refractive structures densely distributed in the dermis. The key distinguishing features of LCLE were the different sized structures mainly clustered around hair follicles, while LLP demonstrated dense structures with a scattered distribution. RCM may be used to distinguish between the key features of LS, LPs, LCLE and LLP in children.

Lichen Striatus: An Updated Review.

Lichen striatus is a benign dermatosis that affects mainly children. This condition mimics many other dermatoses. The purpose of this article is to familiarize pediatricians with the clinical manifestations of lichen striatus to avoid misdiagnosis, unnecessary investigations, unnecessary referrals, and mismanagement of lichen striatus. A search was conducted in June 2023 in PubMed Clinical Queries using the key term "Lichen striatus". The search strategy included all observational studies, clinical trials, and reviews published within the past ten years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of this article. Lichen striatus is a benign self-limited T-cell mediated dermatosis characterized by a linear inflammatory papular eruption seen primarily in children. The onset is usually sudden with minimal or absent symptomatology. The eruption in typical lichen striatus consists of discrete, skin- colored, pink, erythematous, or violaceous, flat-topped, slightly elevated, smooth or scaly papules that coalesce to form a dull red, potentially scaly, interrupted or continuous band over days to weeks. Although any part of the body may be involved, the extremities are the sites of predilection. Typically, the rash is solitary, unilateral, and follows Blaschko lines. In dark-skinned individuals, the skin lesions may be hypopigmented at onset. Nails may be affected alone or, more commonly, along with the skin lesions of lichen striatus. The differential diagnoses of lichen striatus are many and the salient features of other conditions are highlighted in the text. Lichen striatus is a self-limited condition that often resolves within one year without residual scarring but may have transient post-inflammatory hypopigmentation or hyperpigmentation. As such, treatment may not be necessary. For patients who desire treatment for cosmesis or for the symptomatic treatment of pruritus, a low- to mid-potency topical corticosteroid or a topical immunomodulator can be used. A fading cream can be used for post-inflammatory hyperpigmentation.

Association between the skin microbiome and lichen striatus hypopigmentation: Cutibacterium acnes as a potential cause.

Lichen striatus (LS) is an acquired skin disorder with a linear pattern along Blaschko's lines. It commonly occurs in childhood, and the lesions spontaneously regress within several months. Although up to 50% of LS cases exhibit hypopigmentation that can persist for several months to years, it is unknown why LS is associated with such a high incidence of hypopigmentation compared to other inflammatory skin diseases. Therefore, this study aimed to analyse the differences in the skin microbiome between LS patients with and without hypopigmentation. Differences in skin microbiome were analysed using whole genome sequencing of skin biopsies and subsequent bioinformatics analyses. Some microbes commonly found in hypopigmented skin disorders, including Cutibacterium acnes, were more abundant in patients with LS showing hypopigmentation than in those not showing hypopigmentation. The skin microbiota may be involved in the development of hypopigmentation in LS and may be considered a treatment target to reduce LS duration and hypopigmentation.

Clinical Manifestations of European Borreliosis on the Skin in Acute, Subacute and Chronic Disease.

Lyme borreliosis is a multisystemic infection caused by the spirochete Borrelia burgdorferi. Erythema migras is the main clinical marker of the disease. This study aimed was to investigate the frequency and clinical manifestations of European borreliosis on the skin, and to determine the significance of these findings for diagnosis and therapy. A retrospective-prospective clinical study of outpatients treated and monitored in a private clinic of an infectologist was conducted over nine years from to 2013-2021. The study was clinical, descriptive and analytical in nature. In the investigated period, 509 (30.8%) patients with borreliosis symptoms were treated. EM in our patients occurred under the following conditions: a) ringed redness, b) redness of target cels and d) continuous round or oval redness of different sizes of individual redness, or multiple occurrences with primary dissemination. Skin changes with multiorgan chronic symptoms of borreliosis occurred in 67.7% of cases the including: walking redness of different shapes and sizes, pink borreliosis stretch marks, white borreliosis stretch marks, borreliosis palms and soles, psoriatic changes, Acrodermatitis chronica atrophicans, Scleroderma circumscripta-morphae, Erythema nodosum, Granuloma anulare and Lichen striatus et atrophicans. Of the 509 patients treated for borreliosis, 32.3% with multi-organ symptomatology had no skin changes. The skin manifestations of European borreliosis are multi-layered and Erythema migrans are basic, but not the only markers of the disease. 'Pink borreliose stretch marks, "white borreliosis striae", "borreliosis palms or soles", and intermittent redness accompanied by itching are unique markers for the diagnosis of chronic borreliosis, if they are manifested.

A case of Recurred Lichen Striatus Involving Fingernail Misdiagnosed as a Periungual Wart

A case of Recurred Lichen Striatus Involving Fingernail Misdiagnosed as a Periungual Wart

Clinical and epidemiological profile of lichen striatus in children-Experience from a tertiary care hospital.

We analyzed records of 30 patients with lichen striatus (age < 18 years) in this retrospective study. Seventy percent were females and 30% were males with a mean age of diagnosis of5.38 ± 4.22 years. The most common age group affected was 0-4 years. The mean duration of lichen striatus was 6.66 ± 4.22 months. Atopy was present in 9 (30%) patients. Although LS is a benign self-limited dermatosis, long-term prospective studies with a greater number of patients will help in better understanding of the disease including its etiopathogenesis and association with atopy.

Preliminary evaluation of penile papule dermatoses with reflectance confocal microscopy in children.

Owing to their similar appearance, lichen striatus (LS), lichen nitidus (LN), juvenile xanthogranuloma (JXG), and molluscum contagiosum (MC) on the penis often lead to misdiagnosis and missed diagnosis, especially in children. In vivo evaluation of penile dermatoses with reflectance confocal microscopy (RCM) is helpful in the diagnosis of these ambiguous lesions in children. We recruited 12 patients with LS, nine with LN, seven with JXG, and nine with MC and evaluated the characteristics and distinguishing features of the four kinds of papule dermatoses on the penis using RCM. The four dermatoses all had unique RCM features. LS generally showed focally destroyed dermal papillary rings, with numerous mononuclear cell clusters aggregated inside the papillary rings, and highly refractive clumps were observed. For LN, the dermal papillary rings were completely destroyed and arranged in a solitary, enlarged, cavity-like structure, in which round cells, particulate matter structures, and plump cellular structures were aggregated; the adjacent skin was completely normal. In JXG, the dermal papillary rings were significantly dilated, and the superficial dermis was filled with different-sized large bright ring cells; smaller, refractive, roundish structures; and particulate matter. For MC, the normal structures completely disappeared; the lesions were arranged in a crater-shaped structure; and a mass-like substance formed by the aggregation of multiple, uniform, roundish structures was observed within the crater. RCM allows for real-time visualization of major key diagnostic and distinguishing features of four papule dermatoses, LS, LN, JXG, and MC, on the penis in children.

Clinico-Epidemiological Study of Papulosquamous Disorders in Childhood at a Tertiary Care Hospital in South India

Introduction: Papulosquamous disorders in children differ from those in adults in terms of presentations, treatments, and prognosis. The aim of this study was to add to the existing data regarding the presentation of pediatric papulosquamous disorders and analyze the metabolic parameters in children with psoriasis. Materials and Methods: This observational study included 83 patients (age, 0–18 years) with clinically diagnosed papulosquamous disorders. Demographic data and detailed clinical history were collected followed by a detailed clinical examination. In children with psoriasis, we assessed the parameters of metabolic health, such as anthropometry and blood chemistry. The outcomes are expressed as percentages and proportions. Results: Papulosquamous disorders constituted 2.3% of all the pediatric dermatoses with a male-to-female ratio of 1.7:1. They were commonly noted in the age group of 7–12 years. Psoriasis vulgaris (26.5%) was the most common disease followed by lichen planus (19.2%), seborrheic dermatitis (16.8%), pityriasis rosea (13.2%), lichen striatus (12%), lichen nitidus (7.2%), pityriasis lichenoides chronica (3.6%), and pityriasis rubra pilaris (1.20%). None of the 22 patients with psoriasis fulfilled the criteria for metabolic syndrome. However, aberrant serum levels included elevated fasting glucose (n = 5, 22.7%), elevated fasting triglycerides (n = 3, 13.6%), and decreased high-density lipoproteins (n = 2, 9.1%). Anthropometric abnormalities were also not noted. Conclusions: Understanding the morphological and epidemiological features of pediatric papulosquamous disorders can aid in early diagnosis, treatment, and counseling the patients and parents, which can alleviate their anxiety and improve the psychological distress.

Linear Psoriasis: A Rare and Often Underdiagnosed form of Psoriasis in Children

Blaschko-linear psoriasis (PBL) is a rare form of psoriasis that presents as longitudinal lines on the skin, along Blaschko lines. This form of psoriasis is often observed in children and can be difficult to distinguish from other acquired Blaschko linear dermatoses such as inflammatory linear verrucous epidermal nevus (ILVEN) and lichen striatus. The prevalence of PBL is unknown, but it is generally observed in children and is more common in boys than in girls. The clinical and histological similarity of PBL to ILVEN presents a diagnostic challenge. In this case report, we present the case of a 7-year-old child with PBL and discuss the diagnostic and therapeutic aspects of this rare form of psoriasis. We were able to confirm the diagnosis of PBL after treatment with white petroleum jelly and salicylic acid petroleum jelly 5% resulted in a significant improvement of the lesions. Topical treatments, phototherapy, and systemic medications can be used in the case of PBL. It is important to select the most appropriate treatment based on the severity of the lesions, the location, and the patient's tolerance, and to keep in mind that PBL can have long-term effects on the quality of life of patients and their families.

An Unusual Presentation of Lichen Striatus.

An Unusual Presentation of Lichen Striatus.

Blaschkitis or Lichen Striatus

Blaschkitis is an uncommon inflammatory dermatosis of unknown etiology, usually affecting adults. It is characterized by unilateral linear pruritic eruptions along the Blaschko's lines, usually seen on the trunk. Here, we report a case of this rare disorder and have put forward an argument why it is different from lichen striatus.

Presentation of a Case and Proposal of a Novel Hypothesis about the Pathogenesis of Lichen Striatus

Presentation of a Case and Proposal of a Novel Hypothesis about the Pathogenesis of Lichen Striatus

Clinico-pathological correlation of linear dermatoses along the lines of Blaschko: An observational study

Several epidemiological studies have described linear dermatoses; however, only few studies have correlated linear dermatoses along Blaschko’s lines with the histopathological findings. The aims of this study were to investigate the clinical patterns of various linear dermatological lesions along Blaschko’s lines and investigate the correlations between these dermatological lesions and their histopathological features. Patients who attended our dermatology out-patient department with linear dermatoses along the Blaschko’s lines were included in the study. Detailed history was obtained, clinical examination was performed, and a final provisional clinical diagnosis was noted. Subsequently, biopsy of the lesions was performed for histopathological examination. Of 62 patients who presented with linear lesions along the Blaschko’s lines, 45 patients underwent biopsy and histopathological examination. Of 45 patients who underwent biopsy, clinico-pathological correlation was observed in 100% of those diagnosed with lichen striatus and linear morphea, 89% of those diagnosed with hypomelanosis of Ito, 80% of those diagnosed with linear epidermal nevus, 75% of those diagnosed with lichen planus, and 67% of those diagnosed with nevus depigmentosus. The importance of correlation of linear lesions with their histopathological features in dermatology cannot be over emphasized. However, 100% correlation may be wishful thinking, and a correlation can help choose the appropriate line of management. Our results highlight this discrepancy and add to the knowledge on linear dermatosis.

A velősánc sejtek klinikai és (dermato) pathológiai jelentősége. Blaschko vonalak és dermatózisok. Neurocristopathiák

In the course of their migration the neural crest cells reach all parts of the developing embryo. The frst wave of the derivatives of these cells the melanoblasts and melanocytes harbour in the epidermis and hair follicles during the dorsolateral migration. A number of signal molecules and proteases play an important role in the course of melanocyte migration through the extracellular matrix. The Mongolian spots appear as a consequence of the transient inhibition of melanocyte migration and in the case of fnal obstruction the Ota-, or. Ito nevuses. The Blaschko lines based on cutaneous mosaicism are of great diagnostic importance and on the ground of these lines the blaschkitises can appear under the exogenous factors. The blaschkolinear acquired infammatory skin eruption (BLAISE) is an acquired infammatory process. One of its variants is the lichen striatus and the other is the blaschkitis. The blaschkolinear dermatoses can appear usually as a nevoid disease. The pathological development of the neural crest cells can induce pathological processes in other tissues of the body as well, which may appear in the form of the so-called neurocristopathies including approximately ffty manifestations. The knowledge of the diferent pigmentation forms as well as the pathological symptoms of neurocristopathies is of great importance for the clinican from a diagnostic point of view.

Verrucous epidermal nevus: diagnostic difficulties.

Along Blachko’s lines are distributed diseases with Mendelian inheritance such as incontinentia pigmenti, polygenic hereditary diseases such as psoriasis or atopic dermatitis (3), nevi such as verrucous epidermal nevus (VEN) and its inflammatory variant (1), and acquired diseases such as lichen striatus (LS). All these diseases share a condition of mosaicism, that is, they presuppose the existence of a gene mutation, often post-zygotic, that gives rise to a clone of cells different from all the others. The type of mutated gene is responsible for the different morphology of these diseases, but the distribution on the skin of the mutated clone is always the same; therefore, it does not depend on the gene, but on the time in which the mutation occurred and on the stereotyped movements of the migrations that skin cells undergo during fetal life. If the nevus is very extensive and therefore secondary to an early mutation, other organs may be involved such as the nervous system, the eye, the skeletal system, as happening in epidermal nevus syndrome (4) or even some gonadal cells with the risk that the mutation is transmitted to the zygote of the offspring thus giving rise to a generalized inherited disease (5). VEN is usually present at birth; when it is localized in hidden locations or when it initially manifests with just hyperpigmented lesions it may become evident later. However, it is exceptional that it manifests itself at 8 years as in the present case. Its earliness and its morphology are able in most cases to easily differentiate it from an acquired inflammatory condition such as LS. LS is a self-healing inflammatory skin disease, usually asymptomatic, which affects the first years of age, usually between 5 and 15 years, and is distributed linearly along Blaschko’s lines, suggesting that on the line in which it occurs there is a clone of mutated cells as a result of a post-zygotic mutation: this mutation would give the cells involved a particular susceptibility towards an exogenous agent that, upon its arrival, would cause the transient inflammatory reaction (2). There are various hypotheses on the pathogenetic mechanisms that lead to the inflammatory reaction and its spontaneous regression. The present case has posed problems of differential diagnosis between VEN and LS. The histological findings were not able to eliminate the clinical doubt, indeed they added another possible differential diagnosis, i.e. inflammatory linear verrucous epidermal nevus. The latter diagnosis was discarded due to the lack of itching and obvious clinical signs of inflammation. Only prolonged clinical observation over time resolved the diagnostic doubt thanks to the persistence of the lesions and the greater evidence of papillomatous and warty structures.