Nail lichen striatus: Is dermoscopy useful for the diagnosis?
dermoscopy
lichen striatus
linear dermatosis
nail disorders
onychodystrophy
Journal
Pediatric dermatology
ISSN: 1525-1470
Titre abrégé: Pediatr Dermatol
Pays: United States
ID NLM: 8406799
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
pubmed:
31
7
2019
medline:
1
5
2020
entrez:
31
7
2019
Statut:
ppublish
Résumé
Lichen striatus is a unilateral inflammatory dermatosis that rarely affects the nail unit. When the inflammation involves the nail unit, classic lichenoid nail changes are easily detectable, more often limited to only one portion of the nail. Usually the nail dystrophy coexists with periungual skin papules following Blaschko's lines, but it could also be an isolated feature. Because a nail unit biopsy presents difficulties in execution, especially in a child, the aim of our study has been to describe the nail unit dermoscopy features of lichen striatus hoping to provide a valid aid to clinicians in the diagnosing this rare disorder. We reviewed the images of five pediatric patients with a clinical diagnosis of lichen striatus. Data about sex, age, localization, predisposing/triggering factors, and associated disorders are reported. The diagnosis of lichen striatus can be challenging as there are clinically overlapping features with related dermatoses. A common diagnostic pitfall occurs with inflammatory linear verrucous epidermal nevus and lichen planus. Involvement of only one part of the nail plate with linear longitudinal fissuring, ridging, and distal splitting, especially if seen with perionychial skin lesions, is characteristic of lichen striatus. Nail lichen striatus is rare, and there is sparse published literature on it. When the changes in lichen striatus are limited to the nail, the diagnosis may easily be missed. We therefore believe that dermoscopy is an important diagnostic maneuver, which should be integrated into the evaluation of patients with potential lichen striatus, and in particular is helpful for clinicians unwilling or unable to perform a nail unit biopsy.
Sections du résumé
BACKGROUND/OBJECTIVES
OBJECTIVE
Lichen striatus is a unilateral inflammatory dermatosis that rarely affects the nail unit. When the inflammation involves the nail unit, classic lichenoid nail changes are easily detectable, more often limited to only one portion of the nail. Usually the nail dystrophy coexists with periungual skin papules following Blaschko's lines, but it could also be an isolated feature. Because a nail unit biopsy presents difficulties in execution, especially in a child, the aim of our study has been to describe the nail unit dermoscopy features of lichen striatus hoping to provide a valid aid to clinicians in the diagnosing this rare disorder.
METHODS
METHODS
We reviewed the images of five pediatric patients with a clinical diagnosis of lichen striatus. Data about sex, age, localization, predisposing/triggering factors, and associated disorders are reported.
RESULTS
RESULTS
The diagnosis of lichen striatus can be challenging as there are clinically overlapping features with related dermatoses. A common diagnostic pitfall occurs with inflammatory linear verrucous epidermal nevus and lichen planus. Involvement of only one part of the nail plate with linear longitudinal fissuring, ridging, and distal splitting, especially if seen with perionychial skin lesions, is characteristic of lichen striatus.
CONCLUSIONS
CONCLUSIONS
Nail lichen striatus is rare, and there is sparse published literature on it. When the changes in lichen striatus are limited to the nail, the diagnosis may easily be missed. We therefore believe that dermoscopy is an important diagnostic maneuver, which should be integrated into the evaluation of patients with potential lichen striatus, and in particular is helpful for clinicians unwilling or unable to perform a nail unit biopsy.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
859-863Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Patrizi A, Neri I, Fiorentini C, Bonci A, Ricci G. Lichen striatus: clinical and laboratory findings in 115 patients. Pediatr Dermatol. 2004;21:197-204.
Taieb A, El Youbi A, Grosshans E, Maleville J. Lichen striatus: a Blaschko linear acquired inflammatory skin eruption. J Am Acad Dermatol. 1991;25:637-642.
Shepherd V, Lun K, Strutton G. Lichen striatus in adult following trauma. Australas J Dermatol. 2005;46:25-28.
Baran R, Dupre A, Lauret P, Puissant A. Lichen striatus with nail involvement. Report of 4 cases and review of the 4 cases in the literature. Ann Dermatol Venereol. 1979;106:885-891.
Coto-Segura P, Costa-Romero M, Gonzalvo P, Mallo-García S, Curto-Iglesias JR, Santos-Juanes J. Lichen striatus in an adult following trauma with central nail plate involvement and its dermoscopy features. Int J Dermatol. 2008;47:1324-1325.
Kim M, Jung HY, Eun YS, Cho BK, Park HJ. Nail lichen striatus: report of seven cases and review of the literature. Int J Dermatol. 2015;54:1255-1260.
Karp DL, Cohen BA. Onychodystrophy in lichen striatus. Pediatr Dermatol. 1993;10:359-361.
Markouch I, Clerici T, Saiag P, Mahe E. Lichen striatus with nail dystrophy in an infant. Ann Dermatol Venereol. 2009;136:883-886.
Tosti A, Peluso AM, Misciali C, Cameli N. Nail lichen striatus: clinical features and long term follow up of 5 patients. J Am Acad Dermatol. 1997;36:908-913.
Goskowicz MO, Eichenfield LF. Onychodystrophy with lichen striatus. Pediatr Derm. 1994;11:282-283.
Kim DW, Kwak HB, Yun SK, Kim HU, Park J. Dermoscopy of linear dermatosis along Blaschko's line in childhood: Lichen striatus versus inflammatory linear verrucous epidermal nevus. Int J Dermatol. 2017;44:e355-e356.
Alessandrini A, Starace BM, Piraccini BM. Dermoscopy in the evaluation of nail disorders. Skin Appendage Disord. 2017;3:70-82.
Tosti A, Piraccini BM, Cambiaghi S, Iorizzo M. Nail lichen planus in children: clinical features, response to treatment and long-term follow up. Arch Dermatol. 2001;137:1027-1032.
Goettmann S, Zaraa I, Moulonguet I. Nail lichen planus: epidemiological, clinical, pathological, therapeutic and prognosis study of 67 cases. J Eur Acad Dermatol Venereol. 2012;10:1304-1309.
Stolze I, Hamm H. Lichen nitidus and lichen striatus. Hautarzt. 2018;69:121-126.
Saraswat A, Sandhu K, Shukla R, Handa S. Unilateral linear psoriasis with palmoplantar, nail and scalp involvement. Pediatr Dermatol. 2004;21:70-73.
Cribier B. Rare or unusual forms of psoriasis. Ann Dermatol Venereol. 2012;139:S39-S45.
Lee SH, Rogers M. Inflammatory linear verrucous epidermal naevi: a review of 23 cases. Australas J Dermatol. 2001;42:252-256.
Munro CS. The phenotype of Darier's disease: penetrance and expressivity in adults and children. Br J Dermatol. 1992;127:126-130.
Tosti A, Peluso AM, Fanti PA, Piraccini BM. Nail lichen planus: clinical and pathological study of 24 patients. J Am Acad Dermatol. 1993;28:724-730.
Baran R. The red nail-always benign? Actas Dermosifiliogr. 2009; 100:S106-113.
Baran R, Jancovici E, Sayag J, Dawber RP. Longitudinal melanonychia in lichen planus. Br J Dermatol. 1985;113:369-370.
Tosti A, Ghetti E, Piraccini BM, Fanti PA. Lichen planus of the nails and fingertips. Eur J Dermatol. 1998;8:447-448.
Lallas A, Kyrgidis A, Tzellos TG, et al. Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea. Br J Dermatol. 2012;166:1198-1205.
Iorizzo M, Dahdah M, Vincenzi C, Tosti A. Videodermoscopy of the hyponychium in nail bed psoriasis. J Am Acad Dermatol. 2008;58:714-715.
Starace M, Alessandrini A, Piraccini BM. Nail disorders. In: Lallas A, Erichetti E, Ioannides D, eds. Dermoscopy in General Dermatology. Boca Raton, FL: CRC Press; 2018;270.
Carbotti M, Coppola R, Graziano A, et al. Dermoscopy of verrucous epidermal nevus: large brown circles as a novel feature for diagnosis. Int J Dermatol. 2016;55:653-656.