Lichen striatus clinically manifests as erythema in the form of papules that frequently converge to form a band linear, following Blaschko's Lines.
Histopathology of Lichen Striatus
Upon examining histological sections of lichen striatus, a lichenoid pattern infiltrate is observed that compromises the epidermis, epidermis, which typically appears acanthotic (see Figure 1). This infiltrate can vary from very dense to quite sparse (Figures 1, 2), and it is common to find abundant and melanophages in the superficial portion of the dermis. dermis. Apoptotic keratinocytes are seen in all epidermal layers.
Furthermore, the infiltration pattern usually extends to affect the eccrine sweat structures (Figure 3).
Histopathological Images of Lichen Striatus
Figure 1
Figure 2
figure 3
Special Studies Required for Lichen Striatus
Generally, complementary histopathological studies are not required to confirm the diagnosis.
Differential Diagnosis of Lichen Striatus
The correct differential diagnosis relies heavily on the characteristic clinical presentation of the condition.
Lichen Planus or Lichen Planus-like Lesions (Lichenoid Keratoses): In these conditions, the inflammatory infiltrate usually does not involve the eccrine glands. Additionally, keratinocyte apoptosis is predominantly restricted to the basal layer cell of the epidermis, rather than being observed at all levels, as occurs in lichen striatus.
Juvenile Annular Lichenoid Dermatitis: The histology in this case can be practically indistinguishable, suggesting that annular lichen striatus might represent a manifestation of the same underlying disorder.
Unilateral Laterothoracic Exanthem: This condition can also present inflammatory infiltrates that affect the eccrine structures.
Understanding the histopathological features and differentiating lichen striatus from other similar conditions is crucial for an accurate dermatological diagnosis. While special studies are often not needed, clinical correlation with histological findings defines the appropriate management of this condition.
