Concluded Case

LICHEN STRIATUS

10 years boy, Itching lesions on genetalia since 20 days. No itching and same lesions on the family members, Lesions are limited only on genetalia.

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Nise and good answers . Visual shows pink and violaceous linear band and streak shape on shaft of penis with itching in children and short duration more favour to LICHEN STRIATUS. Thank you Dr. Asv Prasad to diagnosed it first. Differential like 1) ILVEN ruled out by short duration.it is more PRURITIC and inflamed presented from birth. 2) lichen simplex CHRONICUS ..not presented on penile area. 3) linear Lichen planus purplish planar papules may be seen in penile areas, but mainly seen In adults, not band like pattern more itchy. 4) linear porokeratosis not presented on genetal areas.characterstic peripheral scale. 5) lichen nitidus can see on genitals. But presentation is macular tiny lesions on total shaft of penis. If linear from koebnerization rather than Blaschkoid pattern. 6) Scabies NODULAR lesions Intense itch. Nodules may be coalescence appear like linear, but not band like. TREATMENT: Benign, harmless condition. Spontaneous resolution within 6 months. Tacrolimus or momentasome application is beneficial. Tab Antihistamines on your choice. If we want fast result...intralesional therapy.

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Lichen stratus usually resolves within 6 months but may leave temporary pale or dark marks (hypopigmentation or hyperpigmentation). Emollients may be used to help treat dryness or itching, if present. Topical steroids or pimecrolimus cream may clear the lesions

Sorry striatus
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Nise and good answers . Visual shows pink and violaceous linear band and streak shape on shaft of penis with itching in children and short duration more favour to LICHEN STRIATUS. Thank you Dr. Asv Prasad to diagnosed it first. Differential like 1) ILVEN ruled out by short duration.it is more PRURITIC and inflamed presented from birth. 2) lichen simplex CHRONICUS ..not presented on penile area. 3) linear Lichen planus purplish planar papules may be seen in penile areas, but mainly seen In adults, not band like pattern more itchy. 4) linear porokeratosis not presented on genetal areas.characterstic peripheral scale. 5) lichen nitidus can see on genitals. But presentation is macular tiny lesions on total shaft of penis. If linear from koebnerization rather than Blaschkoid pattern. 6) Scabies NODULAR lesions Intense itch. Nodules may be coalescence appear like linear, but not band like. TREATMENT: Benign, harmless condition. Spontaneous resolution within 6 months. Tacrolimus or momentasome application is beneficial. Tab Antihistamines on your choice. If we want fast result...intralesional therapy.

Lichen planus .1.Violaceous color 2. Itching 3. Koebnerization 4. Absence of lesions in other sites .5. Negative family history excludes 'gentle man scabies'

@Dr. P.kishore Kumar Educative case. Nice post.
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Ilven ruled out because ithe leision is oresent since 20 days only. Lp is ruled out that the elementory lesion is neither polygonal, violaciou or wickham sriae are seen.. The only linearly disributed lesion is- lichen striatus which is the diagnosis.

What about Lichen nitidus ??
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Lichen planus

Lichen Striatus > blaschkoid LP. Give a course of oral steroids as therapeutic challenge. No topicals as of now. Lp is wet responsive as compared to LS. Koebnerization is seen in both, so that can't be the differentiator. After the course and diagnosis, Pinecrolimus topical > tacrolimus till resolution. If LS, this is the best time to hit, during the papular : inflamm stage. After this, atrophy will set in.

Lichen stratus. Rx. Tetinoids. Topical moral VitA. Cortisone. n antihistamine

Linear Lichen Planus

May be post inf. Scratch mark due to scabies . or lichen striatus

Benign LLS , self limiting in few months, avoid tight dresses & inner wears, Aloevera gel to apply locally.

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