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KMID : 0363219760140020107
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Korean Journal of Dermatology
1976 Volume.14 No. 2 p.107 ~ p.114
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Clinical and Histopathologic Observation in Patients with Lichen Striatus
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孫淑子/Son, Sook Ja
金源錫/金明烈/李惟信/Kim, Won Suk/Kim, Myong Yol/Lee, Yoo Shin
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Abstract
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Lichen striatus is an uncommon nonspecific inflammatory cutaneous disease of unknown etiology occuring as unilateral and linear distribution on extremities and healing spontaneously within a few mont-is to a year. Clinically it is composed of small lichenoid papules which tend to be grouped and coalesced to form either a continuous or an interrupted hypopigmented band and is not usually accompanied by any subjective symptoms. The principal histologic features are an infiltrate composed of lymphocytes and histiocytes around papillary vessels and usually also around some of the deeper vessels and skin appendages and consequent secondary changes of the epidermis.
We present the results of clinical and histopathologic observation in 19 patients. with lichen striatus observed at Department of Dermatology, National Medical Center and Seoul National University Hospital during 4 years´ period from 1972 to 1976 which would be the first recorded report on this rare disease in Korea.
1. Clinical Observation:
Among the 19 patients, 10 were female and 9 were male; 15 were under 10 years of age and 4 were over 10 years of age. Duration of the eruption varied from 1 week to 4 years and average duration was 9.6 months at the time of the first visit.
It was unilateral in all cases and affected the upper extremities in 9 and the lower extremities in 8 instances. The eruption extended onto the upper part of the trunk. in 2 cases. Only 3 patients had a history of mild intermittent itching sensation.
Characteristically, the eruption consisted of grouped, linear, slightly scaling flat-polygonal papules with varying degrees of hypopigmentation, extending at least one-third of the length of an extremity.
2. Histopathologic observation :
Skin biopsy was performed in 13 cases.
The epidermal changes consist of mild diffuse hyperkeratosis (13 cases), focal parakeratosis (5 cases), varying degree of atrophy of malpighian layer (7 cases), mild acanthosis (2 cases), intercellular and intracellular edema (8 cases), exocytosis of lymphocytes (7 cases), focal basal cell disruption (11 cases), and dyskeratotic cells (colloid body) (2 cases). Dermal changes include mild to moderate perivascular lymphocytic and histiocytic infiltrate mostly on the level of papillary dermis. Also, there was chronic inflammatory cell infiltrate around hair follicle and sweat glands and ducts in 7 cases respectively, which seems to be peculiar in this disease. Overall histologic findings in our cases are generally consistent with those of the primary phase of the so-called lichenoid tissue reaction of Pinkus.
The possible pathogenetic mechanism of the linear eruption and immunobiologic interpretation of the lichenoid tissue reaction were literally reviewed.
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