Lichen striatus witl nail involvement
Lichen striatus is a condition of unknown etiology, occurring more often in children as
erythematous papules that develops in a linear pattern.
A 5-year-old boy was referred for evaluation of erythematous papules covered with fine
desquamation coalesced into a band extending down the left forearm, over the dorsum of the hand and onto the thumb.
Also nail dystrophy like longitudinal ridging affecting the lateral part of the thumb nail was noted. Histopathologic examination of biopsy specimen revealed an epidermis
showing hyperkeratosis, focal parakeratosis, and a dense, lymphocytic, inflammatory infiltrate, both around the capillaries and epidermal appendages in the papillary and
reticular dermis. In the 6-month follow-up period, the cutaneous lesions resolved but the nail lesion did not improve.
Nail involvement in lichen striatus is uncommon occurring most often in children. Nail
involvement is more frequent on the fingers. Partial or total onychodystrophy accompanied by skin lesions are common clinical features of nail involvement. Nail changes may occur before, after and simultaneously with the cutaneous eruption.
The onychodystrophy disappears after the regression of the cutaneous lesions.