Title:Lichen Striatus: An Updated Review
Volume: 21
Issue: 3
Author(s): Alexander K.C. Leung*, Joseph M. Lam, Benjamin Barankin and Kin Fon Leong
Affiliation:
- Department of Pediatrics, The University of Calgary, Alberta Children’s Hospital, Calgary, Alberta, Canada
Keywords:
Blaschkitis, blaschko lines, erythematous flat-topped papules, lichen striatus albus, linear band, nail lichen striatus, post inflammatory hyperpigmentation, hypopigmentation.
Abstract:
Background: Lichen striatus is a benign dermatosis that affects mainly children. This
condition mimics many other dermatoses.
Objectives: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
