Lichen striatus is a fairly common, self limited, unilateral (single sided) eruption with a linear shape. Girls out number boys 2 to 1; the mean age at diagnosis is 3 years (6 months to 14 years). Discrete, red or flesh-colored, flat-topped, thickened papules with scale erupt suddenly, then combine in several areas to form a linear band that may extend the entire length of an extremity. The 1 to 3 mm papules form a band 1 to 3 cm wide, either continuous or interrupted, that progress down the extremity. In darker skinned individuals white or light marks predominate.
Lesions extending to the upper nail fold affect the nail. Sometimes the nail alone may be involved for months before the appearance of a linear band extending up the extremity. Extremities are most often involved, but may extend from the trunk to the extremity. Lesions usually do not cause irritation, but at times itching is intense. Spontaneous involution occurs. The mean duration is 9.5 months (4 weeks to 3 years). Temporary darkening of the skin follows resolution in 50% of cases. A biopsy is useful when the diagnosis is in doubt. Lesions can be resistant to treatment.
There have been reported cases in siblings. Also seasonal variation has been known to occur with the spring and summer being the most common. Endemic out breaks have been reported. These features suggest viral cause but this has not been identified.
Application of topical steroids may help this condition, but sometimes intralesional steroids are more effective. Several courses of treatment may be necessary.
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