Lichen striatus L44.2

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 06.01.2021

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Synonym(s)

BLAISE; Blaschkitis; Blaschko linear acquired inflammatory skin eruption; linear dermatitis; Linear lichenoid dermatosis

History
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Balzer and Mercier 1898; Senear and Caro 1941

Definition
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Acquired, chronic, stripe-shaped, inflammatory dermatosis (lichen planus as cutaneous mosaic dermatosis) of unknown etiology following the Blaschko lines (see remarks on the Blaschko-linear inflammatory dermatoses)

Manifestation
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Occurs mainly in children and young people.

Localization
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Asymmetrical: mainly arms, legs (less often: neck or trunk).

Clinical features
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Small reddish, usually less symptomatic, lichenoid, psoriasiform or eczematous flat papules confluent to a reddish, 0.5 - 2.0 cm wide, possibly extending over the entire length of the limb (see also ILVEN). After regression (experience shows that skin changes persist for years), long-term post-inflammatory hypo- and hyperpigmentation may be detectable. Sometimes several stripes are affected in the sense of a systematization. If the stripes end at fingers or toes, nail dystrophy may also be present.

Histology
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Image of interface dermatitis with epidermal hyperplasia, circumscribed parakeratosis, single dyskeratotic cells scattered over the entire epithelial band. Slight perivascular lymphocytic infiltrate with low exocytosis and mild spongiosis.

Differential diagnosis
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  • ILVEN: ILVEN is not regarded as a differential diagnosis, since lichen striatus is considered by many to be a variant of ILVEN, or both clinical pictures are to be subsumed under the term"Blaschko-linear inflammatory dermatoses".
  • The term "Blaschkitis" (Grosshans) is probably synonymous with Lichens striatus in adults.
  • Nevus verrucosus unius lateralis: In this clinical picture, also aligned in the Blaschko lines, the inflammatory component is missing.
  • Lichen planus linearis (histological clarification)
  • Linear psoriasis (histological clarification)

Therapy
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Informing the patient about the harmlessness of the findings, bland skin care (e.g. Ungt. emulsif. aq.)

Progression/forecast
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Formation in 2 to 4 weeks, regression in a period of about 3 months, possibly up to a year, but persistence for years is also possible. Recurrences after healing can occur (as with ILVEN) (see also comments on Blaschko-linear inflammatory dermatoses).

Literature
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  1. Fujimoto N et al (2003) Facial lichen striatus: successful treatment with tacrolimus ointment. Br J Dermatol 148: 587-590
  2. Gokdemir G et al (2003) Lichen striatus associated with chronic plaque psoriasis in an adult. J Eur Acad Dermatol Venereol 17: 617-619
  3. Hofer T (2003) Lichen striatus in adults or 'adult blaschkitis'? There is no need for a new naming. Dermatology 207: 89-92
  4. Kavak A, Kutluay L (2002) Nail involvement in lichen striatus. Pediatric Dermatol 19: 136-138
  5. Luther H et al (1990) Naevoid psoriasis, psoriasiform ILVEN or unusual lichen striatus? Nude Dermatol 16: 306-309
  6. Reiter H et al (2000) Lichen striatus or blaschkitis in the adults. Variations of the same entity? Dermatologist 51: 770-773
  7. Senear RD, Caro MR (1941) Lichen striatus. Arch Dermatol Syph 33:116-133
  8. Zhang Y et al (2001) Lichen striatus. Histological, immunohistochemical, and ultrastructural study of 37 cases. J Cutan Pathol 28: 65-71

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 06.01.2021