Lichen Striatus Workup

  • Author: June Kim, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 11, 2012
 

Procedures

Skin biopsy can be performed to confirm the diagnosis of lichen striatus, but this is rarely necessary.

In ambiguous cases, direct immunofluorescence with staining for Civatte bodies has been proposed to distinguish between lichen planus and lichen striatus. Stains for immunoglobulin M, immunoglobulin G, and complement C3 are positive in lichen planus and negative in lichen striatus.

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Histologic Findings

The histopathologic results vary depending on the stage of evolution. Often, a polymorphic epidermal reaction pattern with variable spongiotic and lichenoid changes is seen in lichen striatus. However, unlike lichen planus, lichen striatus may result in a dense, usually perivascular, lymphohistiocytic infiltrate that extends deep into the dermis and that surrounds the hair follicles and eccrine sweat glands and ducts. Granulomatous inflammation may also be present.

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Contributor Information and Disclosures
Author

June Kim, MD  Mohs Surgery Fellow, Department of Dermatologic Surgery, Yale Medical Center

June Kim, MD, is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Medical Association, American Society for Dermatologic Surgery, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Wingfield Rehmus, MD, MPH  Dermatologist, BC Children's Hospital, Vancouver, British Columbia

Wingfield Rehmus, MD, MPH is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Daniel J Hogan, MD  Clinical Professor of Internal Medicine (Dermatology), Nova Southeastern University College of Osteopathic Medicine; Investigator, Hill Top Research, Florida Research Center

Daniel J Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, and Canadian Dermatology Association

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Paul Krusinski, MD  Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Nelly Rubeiz, MD, and Amal Mehanna, MD, to the development and writing of this article.

References

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Extensive unilateral lichen striatus that affects both the upper and lower extremities. Grouped keratotic lichenoid papules form plaques over the leg.
Lichen striatus over the inner thigh.
Hypopigmented lichen striatus over the leg.
 
 
 
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