What are the other Names for this Condition? (Also known as/Synonyms)

• LS (Lichen Striatus)

What is Lichen Striatus? (Definition/Background Information)

• Lichen Striatus (LS) is an uncommon skin condition that is predominantly observed in young children. It manifests in the form of several pink-red rashes that string together to form linear and curving bands on the skin
• The cause of the condition is not well understood, but some experts believe that it may be due to certain viral infections, injury, or vaccinations in children. Lichen Striatus is a self-limited condition and no treatment is generally necessary

Who gets Lichen Striatus? (Age and Sex Distribution)

• Lichen Striatus is observed in children between the ages of 5 and 15 years, in nearly 50% of the cases. The remaining cases are observed outside this age range, rarely even in adults
• Both male and female genders are affected, although a female predominance is observed (female-male ratio is 2:1 to 3:1)
• Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Lichen Striatus? (Predisposing Factors)

No risk factors have been clearly identified for Lichen Striatus. Some researchers have proposed the following risk factors or triggering factors:

• Infection by certain viruses
• Certain vaccinations such as Bacillus Calmette-Guerin (BCG)
• Injury/trauma
• Family history of allergies such as asthma, allergic rhinitis, or eczema
• Use of certain medications
• Vitiligo

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Lichen Striatus? (Etiology)

The exact cause of formation of Lichen Striatus is not well-established. The skin rashes are observed along the Blaschko lines on the body.

• Medical researchers believe that it may arise due to a complex set of factors including environmental, genetic, and immunologic
• The condition does not spread from one individual to another through physical contact or sharing of items

What are the Signs and Symptoms of Lichen Striatus?

The signs and symptoms of Lichen Striatus may include the following:

• Appearance of distinctively flat, scaly, pinkish, or flesh-colored bumps on skin
• Over a few weeks, these flat eruptions/lesions form a thin band that are linear or curving
• In some, the rashes are inflamed with reddish discoloration
• The bands may be between 2 to 20 mm in width
• Mild to severe itching may be present
• The lesions are commonly observed along the arms and legs
• Less commonly, they may be seen on the face, neck, chest, back, and buttocks
• The nails may also be rarely affected; nails may split and be fragile

How is Lichen Striatus Diagnosed?

In most cases, Lichen Striatus may be diagnosed following a visual/physical examination. However, if necessary, a few diagnostic tests may be performed:

• Physical examination and a complete medical history; a dermatologist will carefully examine the lesions to help in the diagnosis
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Blood tests, to rule out other causes such as infections
• Potassium hydroxide (KOH) test: The KOH prep involves microscopic observation of skin scrapings for structures belonging to fungi
• Allergy skin test
• Skin biopsy: A biopsy of the lesion is usually performed to confirm the diagnosis. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: A skin tissue biopsy is generally not necessary but may be performed to rule out other conditions or infections.

A differential diagnosis to eliminate other conditions may be considered, before arriving at a definitive diagnosis. These may include:

• Annular lichenoid dermatitis
• Inflammatory linear verrucous epidermal nevus (ILVEN)
• Lichen nitidus
• Lichen simplex chronicus
• Linear Darier disease
• Linear lichen planus
• Linear psoriasis  
• Nevus unius lateris
• Nongenital warts  
• Porokeratosis
• Tinea corporis
• Unilateral laterothoracic exanthem

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Lichen Striatus?

Significant complications of Lichen Striatus are not generally observed. However, sometimes the following may occur:

• Scarring in the form of darkened or lightened skin color
• Individuals may have emotional and psychological stress due to the constant rubbing/scratching and cosmetic issues arising from the scaly, leathery skin

How is Lichen Striatus Treated?

Currently, there is no specific treatment available for Lichen Striatus. However, in a majority of individuals, the condition resolves by its own without any treatment.

• If necessary, topical creams and applications may be recommended to reduce discomfort and dryness
• Persistent lesions may be treated using photodynamic therapy
• Tacrolimus may be administered for nail abnormalities

How can Lichen Striatus be Prevented?

Currently, there are no available guidelines or measures to prevent Lichen Striatus.

• However, maintaining hygiene, keeping the skin moisturized, and avoiding the tendency to itch, can help control the symptoms and prevent from worsening of the skin texture
• Clipping the nails short, especially in children, can be beneficial; it may keep them from scratching the lesions

What is the Prognosis of Lichen Striatus? (Outcomes/Resolutions)

The prognosis of Lichen Striatus is generally excellent since it is a self-limited condition. However, a resolution of the condition may take a few months to even up to a year.

Additional and Relevant Useful Information for Lichen Striatus:

Presently, there is no evidence to prove that dietary factors have an influence on Lichen Striatus.