Lichen Striatus Workup

Updated: Jun 04, 2018
  • Author: June Kim, MD; Chief Editor: Dirk M Elston, MD  more...
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Workup

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. Lymphoid infiltrates in the eccrine coil may mimic lupus or syringotropic mycosis fungoides, and the dense interface dermatitis may mimic conventional mycosis fungoides. [34, 35]  Granulomatous inflammation may also be present.

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