Lichen striatus pathology

Author: A/Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, 2013.

Lichen striatus presents as as an erythematous papules which often join together to form a linear band following Blaschko lines.

Histology of lichen striatus

In lichen striatus, sections show a lichenoid infiltrate involving an epidermis which is usually acanthotic (figure 1). The infiltrate can be very dense or quite sparse (figures 1, 2) and there may be numerous melanophages in the superficial dermis. Apoptotic keratinocytes are usually seen at all levels of the epidermis.

The infiltrate typically extends to involve eccrine structures (figure 3).

Special studies of lichen striatus

None are generally needed.

Differential diagnosis of lichen striatus

The clinical presentation is helpful.

Lichen planus or lichen planus-like keratosis – The infiltrate does not usually involved eccrine glands and apoptotic keratinocytes are mainly limited to basal epidermis rather than all levels of the epidermis.

Annular lichenoid dermatitis of youth – The histology may be identical and annular lichen striatus may actually be the same disorder.

Unilateral laterothoracic exanthem – May also exhibit eccrine infiltrates

Related information

Email Newsletter

Would you like to receive our dermatology updates by email?


Submit your images

We're seeking high-quality photos of skin diseases.  


Machine diagnosis

Watch DermNet's proposal to create a 'Skin Disease Image Recognition Tool' - winner of the 2017 'Clinicians' Challenge Active Award' by the NZ Ministry of Health and HiNZ.

Subscribe to our mailing list

* indicates required
DermNet NZ Newsletter