Lichen striatus (LS) is an idiopathic, acquired, linear inflammatory eruption of childhood.
Although the etiology is unknown, both genetic and environmental factors play a role as LS has been reported to occur in outbreaks and more often in the spring and summer. Also, there is a strong association between LS and atopy.
Most often seen in children 5 to 15 years of age with a median age of 2 to 3 years.
Individual lesions are tiny, 1- to 2-mm, flat-topped, scaly erythematous papules that coalesce to linear plaques (Fig. 8.19).
LS most commonly occurs on the extremities but can also be seen on the face (Fig. 8.20), trunk, and buttocks.
The most characteristic feature is the linear configuration of the lesions along Blaschko lines, the lines of embryonic skin migration. The linear band may be continuous or interrupted (Fig. 8.21).
Length can vary from several centimeters to involvement of an entire extremity.
Presents abruptly and reaches its maximum length within several weeks and then regresses spontaneously within 4 to 12 months or occasionally longer.
In dark-skinned children the eruption may present as linear hypopigmentation.
Nail involvement may occur as an extension of the skin lesion.
Post-inflammatory hypopigmentation may last months to years.
History of abrupt onset and clinical examination will determine the diagnosis.
If diagnosis is in doubt, a skin biopsy will show the characteristic features including a bandlike lymphohistiocytic infiltrate in the dermis and surrounding the eccrine sweat glands and ducts, epidermal hyperkeratosis and focal parakeratosis.
Segmental Vitiligo
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Differential Diagnosis 
Management