To analyze the clinical features, response to treatment, and follow-up of lichen striatus and any associated symptoms or disease, we designed a retrospective study involving 115 affected children at the Pediatric Dermatology Unit of the Department of Dermatology of the University of Bologna, Bologna, Italy. Between January 1989 and January 2000 we diagnosed lichen striatus in 37 boys and 78 girls (mean age 4 years 5 months). We studied their family history and the season of onset, morphology, distribution, extent, duration, histopathology, and treatment of their lichen striatus. We found that family history was negative in all our patients except for two pairs of siblings. The majority of children had the disease in the cold seasons; precipitating factors were found in only five cases. The most frequently involved sites were the limbs, with no substantial difference between upper and lower limb involvement. When lichen striatus was located on the trunk and face, it always followed Blaschko lines; in seven children the bands on the limbs appeared to be along the axial lines of Sherrington. In 70 cases, lichen striatus was associated with atopy. The mean duration of the disease was 6 months and relapses were observed in five children, and in one instance the disease had a prolonged course. Only a few case study series of lichen striatus in children have been reported and ours is the largest to date. The etiology of lichen striatus remains unknown in the majority of our patients. The confirmed association with atopy observed in our patients may be a predisposing factor. It has generally been accepted that lichen striatus follows the lines of Blaschko, and this distribution is a sign of both a topographic and a pathogenetic concept. In patients where lichen striatus is along axial lines, a locus minoris resistentiae, we suppose that this distribution may only be an illusory phenomenon in instances in which the trigger factor prefers this route, consisting of several successive Blaschko lines, but appearing as a single band.

Nevus comedonicus (NC) is an uncommon developmentaldefect of the pilosebaceous apparatus. The individual lesions are large comedones often arranged in groups or in a linear pattern. Nevus comedonicus syndrome (NCS) is a well-defined disorder within the large group of epidermal nevus syndromes. In patients suffering from NCS, the nevus is associated with noncutaneous abnormalities including skeletal defects, cerebral anomalies, and cataracts. We report a 9-year-old boy with open comedones in a linear pattern localized to the right cheek, clinodactyly and polydactyly of the first right finger, bilateral syndactyly of the second and third toes, and some depigmented hairs since birth.

Lichen striatus (LS) is a self-limiting linear papular dermatosis of unknown etiology seen mostly in children. We report LS occurring in two pairs of siblings: two sisters who had LS at an interval of 6 months and a brother and sister who had the dermatosis contemporaneously after an episode of flulike fever. In all four patients family history was positive for atopy. LS is frequently associated with atopic diseases. The abnormal immune status of patients with atopy may be a predisposing factor in the induction of LS. In our patients the simultaneous occurrence of LS in siblings after a flulike fever appears to corroborate the hypothesis that a viral infection is a possible candidate, as other authors have proposed. The rarity of familial cases of LS is, in our opinion, due to the exceptional confluence of difference sporadic events (atopy, viral infection caught at a specific period of life such as childhood, and a genetic predisposition) simultaneously present in the same patient.

Nevus comedonicus (NC) is an uncommon developmental defect of the pilosebaceous apparatus. The individual lesions are large comedones often arranged in groups or in a linear pattern. Nevus comedonicus syndrome (NCS) is a well-defined disorder within the large group of epidermal nevus syndromes. In patients suffering from NCS, the nevus is associated with noncutaneous abnormalities including skeletal defects, cerebral anomalies, and cataracts. We report a 9-year-old boy with open comedones in a linear pattern localized to the right cheek, clinodactyly and polydactyly of the first right finger, bilateral syndactyly of the second and third toes, and some depigmented hairs since birth.

No abstract