A Case of Lichen Striatus in a 31-year old Filipino male

Authors: Monique Lianne C. Lim, MD, Elizabeth P. Prieto, MD, FPDS, Fatima D.C. Jacinto-Calimag, MD, Patricia Anne Nicole O. Ramirez-Ecarma, MD

Abstract

Introduction: Lichen Striatus is a rare, idiopathic, papular eruption that may spontaneously resolve within one to two years. Eruption is characterized by sudden onset, flat-topped papules in a linear or Blaschkoid distribution. Majority of cases are seen in children 4 months to 15 years old, with occasional cases still occurring in adults.

Case Summary: A 31-year old male presents with a 2 ½ month history of multiple, erythematous, pruritic papules on the right arm, gradually becoming hyperpigmented and spreading to the right side of the chest and back distributed along the lines of Blaschko. No other systemic symptoms present. Histopathology results showed hyperkeratosis with foci of parakeratosis, slight spongiosis, irregularly slightly acanthotic epidermis, and a dense bandlike lymphocytic infiltrate, consistent with a diagnosis of lichen striatus. The patient was treated with clobetasol propionate ointment two times a day alternating every two weeks with tacrolimus ointment two times a day to prevent side effects of topical glucocorticoids. Adapalene gel two times a day was also started on the third month. The patient responded well with improvement of lesion thickness and pruritus within 4 months.

Conclusion: Since some lesions of lichen striatus may spontaneously resolve, treatment is mainly for pruritus with topical glucocorticoids. According to literature, retinoids may also be used in combination with topical glucocorticoids for rapid resolution of symptoms specially if there are cosmetic concerns.

 

Citation

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Keywords

lichen striatus, clobetasol, tacrolimus, adapalene

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