- Deepti Gupta, MD
Deepti Gupta, MD
- Assistant Professor of Pediatrics (Dermatology)
- Department of Pediatrics and Division of Dermatology
- Seattle Children's Hospital
- University of Washington School of Medicine
- Erin Mathes, MD
Erin Mathes, MD
- Associate Professor of Dermatology
- Departments of Dermatology and Pediatrics
- University of California, San Francisco
Lichen striatus is an acquired, asymptomatic, and self-limited linear inflammatory skin disorder that predominantly affects children . The eruption is typically unilateral, involves most often the extremities, and follows the lines of Blaschko in a continuous or interrupted pattern. The onset is sudden, with full progression over a few weeks and resolution typically within 6 to 12 months.
This topic will discuss the pathogenesis, clinical manifestations, diagnosis, and treatment of lichen striatus.
Lichen striatus is a relatively uncommon disease that most frequently occurs in children 5 to 15 years of age. However, it may occur at any age, from early infancy to adulthood [2-7]. Lichen striatus has been reported in all ethnic groups and appears to be more common in females [3,5-7]. There are a few reports of familial cases [3,8-12].
The precise etiology of lichen striatus is unknown. Viral infections, trauma, hypersensitivity reactions, vaccines, medications, and pregnancy have been proposed as triggering factors [13-17]. A positive personal or family history of asthma, atopic dermatitis, or allergic rhinitis has been reported in 60 to 85 percent of individuals with lichen striatus, suggesting that atopy may be a predisposing factor [5,18,19].
The distribution of lichen striatus along the lines of Blaschko (lines corresponding to the direction of growth of cutaneous cells during embryogenesis (figure 1)) suggests that lichen striatus is a condition of cutaneous mosaicism, due to somatic (postzygotic) mutations that produce abnormal keratinocyte clones during early embryogenesis. These aberrant clones may remain silent until a triggering event causes a break in immunologic tolerance and initiates an autoimmune response [4,20]. Potential triggers include viral infections, vaccines, trauma, pregnancy, hypersensitivity reactions, and medications [5,9,13-16,21-23].To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Senear FE, Caro MR. Lichen Striatus. Arch Dermatol Syphil 1941; 43:116.
- Peramiquel L, Baselga E, Dalmau J, et al. Lichen striatus: clinical and epidemiological review of 23 cases. Eur J Pediatr 2006; 165:267.
- Kennedy D, Rogers M. Lichen striatus. Pediatr Dermatol 1996; 13:95.
- Taieb A, el Youbi A, Grosshans E, Maleville J. Lichen striatus: a Blaschko linear acquired inflammatory skin eruption. J Am Acad Dermatol 1991; 25:637.
- Patrizi A, Neri I, Fiorentini C, et al. Lichen striatus: clinical and laboratory features of 115 children. Pediatr Dermatol 2004; 21:197.
- Hofer T. Lichen striatus in adults or 'adult blaschkitis'?. There is no need for a new naming. Dermatology 2003; 207:89.
- Taniguchi Abagge K, Parolin Marinoni L, Giraldi S, et al. Lichen striatus: description of 89 cases in children. Pediatr Dermatol 2004; 21:440.
- Patrizi A, Neri I, Fiorentini C, et al. Simultaneous occurrence of lichen striatus in siblings. Pediatr Dermatol 1997; 14:293.
- Racette AJ, Adams AD, Kessler SE. Simultaneous lichen striatus in siblings along the same Blaschko line. Pediatr Dermatol 2009; 26:50.
- Kanegaye JT, Frieden IJ. Lichen striatus: simultaneous occurrence in siblings. Pediatrics 1992; 90:104.
- Yaosaka M, Sawamura D, Iitoyo M, et al. Lichen striatus affecting a mother and her son. J Am Acad Dermatol 2005; 53:352.
- Karempelis PS, Cely SJ, Davis LS. Lichen striatus in a mother and son. Int J Dermatol 2014; 53:e366.
- Dragos V, Mervic L, Zgavec B. Lichen striatus in a child after immunization. A case report. Acta Dermatovenerol Alp Pannonica Adriat 2006; 15:178.
- Karakaş M, Durdu M, Uzun S, et al. Lichen striatus following HBV vaccination. J Dermatol 2005; 32:506.
- Brennand S, Khan S, Chong AH. Lichen striatus in a pregnant woman. Australas J Dermatol 2005; 46:184.
- Lora V, Kanitakis J, Latini A, Cota C. Lichen striatus associated with etanercept treatment of rheumatoid arthritis. J Am Acad Dermatol 2014; 70:e90.
- Hafner C, Landthaler M, Vogt T. Lichen striatus (blaschkitis) following varicella infection. J Eur Acad Dermatol Venereol 2006; 20:1345.
- Toda K, Okamoto H, Horio T. Lichen striatus. Int J Dermatol 1986; 25:584.
- García-Briz MI, Santos-Alarcón S, Fuertes-Prosper MD, Mateu-Puchades A. Lichen Striatus in Childhood: Is It Associated With Atopic Dermatitis? Actas Dermosifiliogr 2017; 108:882.
- Gianotti R, Restano L, Grimalt R, et al. Lichen striatus--a chameleon: an histopathological and immunohistological study of forty-one cases. J Cutan Pathol 1995; 22:18.
- Hwang SM, Ahn SK, Lee SH, Choi EH. Lichen striatus following BCG vaccination. Clin Exp Dermatol 1996; 21:393.
- Shepherd V, Lun K, Strutton G. Lichen striatus in an adult following trauma. Australas J Dermatol 2005; 46:25.
- Coto-Segura P, Costa-Romero M, Gonzalvo P, et al. Lichen striatus in an adult following trauma with central nail plate involvement and its dermoscopy features. Int J Dermatol 2008; 47:1324.
- Keegan BR, Kamino H, Fangman W, et al. "Pediatric blaschkitis": expanding the spectrum of childhood acquired Blaschko-linear dermatoses. Pediatr Dermatol 2007; 24:621.
- Badr D, Abadi R, Kurban M, Abbas O. Plasmacytoid Dendritic Cells and Type I Interferon Signature in Lichen Striatus. Pediatr Dermatol 2016; 33:301.
- Mu EW, Abuav R, Cohen BA. Facial lichen striatus in children: retracing the lines of Blaschko. Pediatr Dermatol 2013; 30:364.
- Litvinov IV, Jafarian F. Images in clinical medicine. Lichen striatus and lines of Blaschko. N Engl J Med 2012; 367:2427.
- Kurokawa M, Kikuchi H, Ogata K, Setoyama M. Bilateral lichen striatus. J Dermatol 2004; 31:129.
- Sato H, Shirai A, Asahina A. Case of lichen striatus presenting with multiple lesions along Blaschko's lines. J Dermatol 2012; 39:802.
- Karp DL, Cohen BA. Onychodystrophy in lichen striatus. Pediatr Dermatol 1993; 10:359.
- Tosti A, Peluso AM, Misciali C, Cameli N. Nail lichen striatus: clinical features and long-term follow-up of five patients. J Am Acad Dermatol 1997; 36:908.
- Kavak A, Kutluay L. Nail involvement in lichen striatus. Pediatr Dermatol 2002; 19:136.
- Kim M, Jung HY, Eun YS, et al. Nail lichen striatus: report of seven cases and review of the literature. Int J Dermatol 2015; 54:1255.
- Feely MA, Silverberg NB. Two cases of lichen striatus with prolonged active phase. Pediatr Dermatol 2014; 31:e67.
- Zhang Y, McNutt NS. Lichen striatus. Histological, immunohistochemical, and ultrastructural study of 37 cases. J Cutan Pathol 2001; 28:65.
- Müller CS, Schmaltz R, Vogt T, Pföhler C. Lichen striatus and blaschkitis: reappraisal of the concept of blaschkolinear dermatoses. Br J Dermatol 2011; 164:257.
- Requena C, Torrelo A, de Prada I, Zambrano A. Linear childhood cutaneous lupus erythematosus following Blaschko lines. J Eur Acad Dermatol Venereol 2002; 16:618.
- Gaitanis G, Nomikos K, Chaniotakis I, et al. Linear cutaneous lupus erythematosus: a subset of childhood cutaneous lupus erythematosus. Lupus 2009; 18:759.
- Muñoz Garza FZ, Manubens Mercadè E, Roè Crespo E, et al. Linear Morphea Mimicking Lichen Striatus in Its Early Presentation. Pediatr Dermatol 2016; 33:e23.
- Kabbash C, Laude TA, Weinberg JM, Silverberg NB. Lichen planus in the lines of Blaschko. Pediatr Dermatol 2002; 19:541.
- Vassallo C, Derlino F, Ripamonti F, Borroni G. Lichenoid cutaneous chronic GvHD following Blaschko lines. Int J Dermatol 2014; 53:473.
- Kennedy FE, Hilari H, Ferrer B, Garcia-Patos V. Lichenoid chronic graft-vs-host disease following Blaschko lines. Actas Dermosifiliogr 2014; 105:89.
- Sertznig P, von Felbert V, Megahed M. Porokeratosis: present concepts. J Eur Acad Dermatol Venereol 2012; 26:404.
- Meziane M, Chraibi R, Kihel N, et al. Linear Darier disease. Dermatol Online J 2008; 14:11.
- Campanati A, Brandozzi G, Giangiacomi M, et al. Lichen striatus in adults and pimecrolimus: open, off-label clinical study. Int J Dermatol 2008; 47:732.
- Jo JH, Jang HS, Park HJ, et al. Early treatment of multiple and spreading lichen striatus with topical tacrolimus. J Am Acad Dermatol 2007; 57:904.
- Sorgentini C, Allevato MA, Dahbar M, Cabrera H. Lichen striatus in an adult: successful treatment with tacrolimus. Br J Dermatol 2004; 150:776.
- Bae JM, Choo JY, Chang HS, et al. Effectiveness of the 308-nm excimer laser on hypopigmentation after lichen striatus: A retrospective study of 12 patients. J Am Acad Dermatol 2016; 75:637.