Pathology of lichen striatus

Lichen striatum presents as a erythematous papules that often come together to form a linear band tracking Blaschko lines.

Histology lichen striatum

In lichen striatus, sections show a lichenoid infiltrate involving a epidermis which is usually acanthotic (figure 1). The infiltrate can be very dense or quite sparse (Figures 1, 2) and there may be numerous melanophages on the surface dermis. Apoptotic keratinocytes they are generally seen on all levels of the epidermis.

The infiltrator usually spreads to involve eccrine structures (figure 3).

Special studies of lichen striatum

Generally none is needed.

Differential diagnosis lichen striatum

The clinical presentation is helpful.

Lichen planus or lichen planus keratosis - The infiltrator does not usually involve eccrine glands and apoptotic keratinocytes are mainly limited to basal epidermis rather than all levels of the epidermis.

Cancel lichenoid dermatitis of youth: histology may be identical and lichen striatum annulare may be the same disorder.

Unilateral laterothoracic exanthema - May also exhibit eccrine infiltrators