Clinical and Histopathological Study of Lichen Striatus(1988-1998)

Won, Young Ho; Park, Chin Young; Lee, Jee Bum; Lee, Seung Chul

Abstract

Lichen striatus (LS) is an uncommon self-limiting, unilateral linear dermatosis of unknown origin. The histopathology of LS often shows a polymorphic epidermal reaction process of variable lichenoid and spongiotic changes having no specific histopathological criteria. This study aim to evaluate the clinical and histopathological features of LS according to clinical involution of the skin lesions. Thirty eight patients of LS during 10 years' period (1988-1998) were divided into three groups depending on the age of the lesion at that time of the biopsy (group I; 15-45 days, II; 60-180 days, III >6 month). In addition, immunohistochemical stain of the S-100 protein was performed in 7 specimens shown epidermal vesicles. The male to female ratio was 1:1.7, and average age was 9.9 years. Average duration of the eruption was 10 months (1 week to 4 years) at the time of the first visit. The total duration from onset to complete resolution was approximately 22 months based on 10 patients, who observed until complete resolution. All skin lesions were unilaterally localized on the upper extremities at 13, the lower extremities at 18, and the trunk at 7. Epidermal changes on the histopathological examination were a focal spongiosis or vacuolar alteration of dermo-epidermal junction in 32 patients, lymphocytic exocytosis in 29, necrotic keratinocytess of spinous latyer in 22, and subcorneal spongiotic vesicles filled with Langerhans' cells and lymphocytes in 12. Dermal alterations included an inflammatory infiltration around skin appendages in 28, band-like inflammatory cell infiltration in 21, superficial perivascular infiltration of inflammatory cells in 13, extravasation of red blood cells in 11, and melanophage in upper dermis in 10. All histological findings were equally distributed between the group I, II, III. This study suggest that characteristic histopathological features of LS are necrotic keratinocytes in basal and spinous layer, subcorneal spongiotic vesicles filled with Langerhans' cells and lymphocytes in epidermis, and inflammatory infiltration around skin appendages in dermis.