Effective Topical Combination Therapy for Treatment of Lichen Striatus in Children: A Case Series and Review
July 2012 | Volume 11 | Issue 7 | Case Report | 872 | Copyright © 2012
Lichen striatus (LS) is an uncommon linear dermatosis that is primarily seen in children from 4 months to 15 years of age. While
some of these eruptions are asymptomatic, others can be quite pruritic. In darker-skinned individuals, post-inflammatory hypopigmentation
can be significant and may provide a cause for concern for the patients and/or their parents. In our case series of 4
patients, we observed rapid resolution of LS by combining a topical retinoid with a topical steroid. To our knowledge, this is the
first report of successful treatment with this kind of combination therapy in the English literature. The patients not only achieved
satisfying cosmesis, but also complete resolution of their pruritus. The most common side effect of topical tazarotene is localized
irritation at treatment sites, but the patients in this particular series tolerated the treatment well.
J Drugs Dermatol. 2012;11(7):872-875.
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Lichen striatus (LS) is an uncommon linear dermatosis primarily seen in children between the ages of 4 months and 15 years. Typically, the lesions consist of pink, red, or flesh-colored flat-topped lichenoid papules arranged linearly, often along the lines of Blaschko. Lesions are usually solitary, but rare cases of multiple lesions distributed bilaterally have been reported.1-3 Lesions occur most often on the limbs, and, less frequently, on the trunk or face.4 Lichen striatus develops at a higher frequency in children with a personal or family history of atopy.5 While some of these eruptions are asymptomatic, others can be quite pruritic. Reports of associated pruritus range from 11% to 34%.5-6 Although LS is usually self-limited, it may last up to 1 to 2 years. Treatment is considered elective for either symptomatic or cosmetic concerns.7 While topical steroids are considered first-line therapy for relief of pruritus, they have not had significant effects on modulating the course or duration of LS.6 In darker-skinned individuals, post-inflammatory hypopigmentation can be significant, and may provide a cause for concern for the patients and/or their parents.
Retinoids have proven to be a successful therapy for treatment of a variety of cornification disorders and are known to modulate keratinocyte proliferation and differentiation.8 In this report, we will provide a case series of LS treated with a combination of a topical steroid and a topical retinoid. In our experience, the addition of a topical retinoid shortens the duration of the treatment and leads to earlier resolution, when compared to treatment with a topical steroid alone. This combination of topical agents also appears to be effective in improving postinflammatory dyspigmentation in patients with darker skin. The most common side effect of the treatment is mild irritation.