Lichen Striatus

Lichen striatus begins as small pink, red or flesh coloured spots which over the course of one or two weeks join together to form a dull red slightly scaly linear band. Lesions elongating to the upper nail fold affect the nail. Sometimes the nail alone may be include for months before the appearance of a linear band extending up the extremity. Extremities are most usually involved, but may extend from the trunk to the extremity.

Lichen striatus generally does not cause any itching or other symptoms. This skin disorder can influence any part of the body, but it is more commonly known to occur on the arms and or legs of a patient. This skin condition peculiar does not cause the patient to feel the need to scratch the rash on their body. Adults are evidently immune to contracting Lichen Striatus.

Instead this disease will only be found in small children which are between the ages of five and ten years old. Clearly any child slightly under or over that age group is not immune to this skin disorder. There is no effective treatment for lichen striatus and in most cases none is requisite. Very strong topical steroids under plastic occlusion may help, but intralesional steroids are more effective. Different courses of treatment may be necessary. Emollients or topical steroids may be used to help treat dryness or itching, if present.

Causes of Lichen striatus

The reason of lichen striatus is unknown. Possibly genetic factors or environmental triggers have a role to perform in its development. Lichen striatus is not dangerous or infectious. About 50% of cases occur in children aged between 5 and 15 years. It appears in females two or three times as often as in males.

Common causes and risk factors of Lichen striatus:

An overactive immune system.
The thyroid disease, pernicious anaemia, vitiligo and alopecia areata.
Genetic, hormonal and infectious components.
Family history of lichen sclerosus.

Signs and Symptoms of Lichen striatus

Lesions generally do not cause irritation, but at times itching is intense. Occassionally a band may extend from the leg onto the buttock or abdomen. Lichen striatus begins as small pink, red or flesh coloured spots that over the course of one or two weeks join together to form a dull red slightly scaly linear band. Sometimes the nail alone may be involved for months before the appearance of a linear band extending up the extremity. Extremities are most often involved, but may extend from the trunk to the extremity.

Sign and symptoms may include the following :

Chronic itching and soreness of the vulval area.
Skin tears or ulcers.
Inflammation and swelling of the affected skin.
Blisters and ulceration.
The splitting and bleeding of the skin.

Treatment for Lichen striatus

There is no effective treatment for lichen striatus and in most cases none is important. Treatment can improve the condition in certain cases. Very strong topical steroids under plastic occlusion may help, but intralesional steroids are more effective. Different courses of treatment may be necessary. The circumcision is the most broadly used therapy for lichen sclerosus. This procedure removes the affected skin, and the disease usually does not recur.

Treatment may include:

Xylocaine jelly will often help to numb the area before intercourse and makes sexual activity more comfortable. This should be applied liberally 15-20 minutes before intercourse.
The new immune modulating creams tacrolimus and pimecrolimus look promising for treating lichen sclerosus.
Other treatments include calcipotriol cream, topical and systemic retinoids.
The use of ultrapotent topical corticosteroid creams and ointments are very suitable for the treatment of lichen sclerosus.
Very strong topical steroids under plastic occlusion may help, but intralesional steroids are more effective.

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