Wickham's drawing - Altmeyers Encyclopedia

Synonym(s)

Weyl-Wickham's stripes; Weyl-Wickham's Stripes; Wickham Phenomenon; Wickham's stripes

Definition
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Whitish netting on the papules of the primary florescence of Lichen planus. The reticulation is especially visible in cases of mucosal infestation. The pattern is well visible on free skin after wetting the papules with olive oil. The cause of this unusual phenomenon has long been disputed. Today, the focal broadening of the stratum granulosum and the reflection caused by this is considered the cause.

Histology
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Heart-shaped hypergranulosis.

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Differential diagnosis
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Dermatofibromas can show a similar dermatoscopic pattern.

Therapy
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See under therapy of the lichen planus and lichen planus mucosae. The Wickham's drawing without further, e.g. erosive mucous membrane changes, does not require therapy. Only a tissue sample should be taken to exclude precancerosis or oral leukoplakia. Regular check-ups by a specialist are recommended.