Clinical features of 57 cases of lichen striatus in children
Objective To investigate the clinical features of lichen striatus in children,so as to assist the early diagnosis and treatment of lichen striatus in children.Methods A retrospective analysis was performed on 57 children with lichen striatus,who initially sought medical care at the the department of dermatology,Children's Hospital Affiliated to the Capital Institute of Pediatrics between November 2020 and November 2021 and were followed up for an average of 1.5 years.The multiple clinical data were collected for further analysis,including general manifestation of skin lesions,results of skin reflectance confocal microscopy examination,treatment results and prognosis.Results Among the 57 pediatric patients,there were 29 males and 28 females.The median age of the patients(IQ 1～IQ3)was 5 years old(2～7 years old),and the median duration of disease was 13.0 months(11.0～15.5 months).Atotal of 61 skin lesions were detected in 57 pediatric patients,with single lesions observed in 53 children and dual lesions present in 4 children.The skin lesions were mainly distributed in the lower limbs(23 lesions),followed by the upper limbs(17 lesions),trunk(14 lesions),nails(5 lesions),and face(2 lesions).According to the morphology,the lesions were mainly divided into three clinical modes,including classic type(47 lesions),hypopigmentation type(8 lesions)and nail involvement type(6 lesions).There were significant differences in the overall course of disease among the three types(H=11.801,P=0.003),with the longest median course of disease in nail involvement type.There were significant differences in the duration of disease activity among the three types(H=12.537,P=0.000),and nail involvement type had a longer median course of disease activity compared to classic type.Out of 61 skin lesions,48 lesions received treatment with external application of 0.03％tacrolimus ointment(or combination with 0.1％mometasone furoate cream)for 1-3 months,and 13 lesions were left untreated or lacked regular medication.Conclusions The clinical manifestations of lichen striatus and its skin manifestations observed through reflectance confocal microscopy exhibit typical characteristics,which can be utilized as diagnostic aids for lichen striatus.The lichen striatus is mainly divided into three clinical modes,including classic type,hypopigmentation type,and nail involvement type.Topical glucocorticoids and(or)calcineurin inhibitors administered during the active phase of the disease can effectively alleviate symptomatic pruritus and reduce the duration of disease activity,without impacting the overall course of the disease.The lichen striatus is a self-limiting disease,resolving spontaneously within a few months without treatment,and exhibiting a favorable prognosis with no scar formation.
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