{"title":"Nail Lichen Striatus and Its Differential Diagnoses","authors":"Aslı Bilgic","doi":"10.1159/000539798","DOIUrl":null,"url":null,"abstract":"Background: Lichen striatus (LS) is a benign, mostly self-limiting dermatological condition, primarily affecting the skin, and sometimes the nails. It is characterised by the sudden onset of a band-like rash, typically following Blaschko lines. The exact cause of LS is not well established, but it is believed to be an abnormal immune response to the altered keratinocyte clone after a triggering event. Summary: Although nail LS is regarded as rare, it is probably underreported. Single-visualised nail dystrophy, especially partial involvement of the nail, with or without skin rash, should prompt the LS diagnosis among differentials. Onychoscopy might be helpful to better visualise the clinical signs. Nail dystrophy often has a prolonged course even after the resolution of skin lesions. Topical steroids, calcineurin inhibitors, and intralesional steroid injections might be an option for symptomatic patients or for severe and prolonged nail dystrophy. Key Messages: (i) Single nail involvement, nail changes located on one portion of the nail, and the presence of typical linear band-like skin rash should prompt the LS diagnosis. (ii) Onychoscopy might be helpful to better visualise the clinical signs and to avoid unnecessary biopsies. (iii) Nail unit biopsy should be performed if the diagnosis is uncertain to exclude nail involvement of more severe and progressive disease course like nail lichen planus and/or nail unit tumours.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Skin Appendage Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000539798","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Lichen striatus (LS) is a benign, mostly self-limiting dermatological condition, primarily affecting the skin, and sometimes the nails. It is characterised by the sudden onset of a band-like rash, typically following Blaschko lines. The exact cause of LS is not well established, but it is believed to be an abnormal immune response to the altered keratinocyte clone after a triggering event. Summary: Although nail LS is regarded as rare, it is probably underreported. Single-visualised nail dystrophy, especially partial involvement of the nail, with or without skin rash, should prompt the LS diagnosis among differentials. Onychoscopy might be helpful to better visualise the clinical signs. Nail dystrophy often has a prolonged course even after the resolution of skin lesions. Topical steroids, calcineurin inhibitors, and intralesional steroid injections might be an option for symptomatic patients or for severe and prolonged nail dystrophy. Key Messages: (i) Single nail involvement, nail changes located on one portion of the nail, and the presence of typical linear band-like skin rash should prompt the LS diagnosis. (ii) Onychoscopy might be helpful to better visualise the clinical signs and to avoid unnecessary biopsies. (iii) Nail unit biopsy should be performed if the diagnosis is uncertain to exclude nail involvement of more severe and progressive disease course like nail lichen planus and/or nail unit tumours.
背景:条纹状苔藓(LS)是一种良性皮肤病,多为自限性,主要影响皮肤,有时也会影响指甲。它的特点是突然出现带状皮疹,典型的皮疹呈布拉什科纹。甲沟炎的确切病因尚不明确,但据信是在诱发事件发生后,对改变的角质细胞克隆产生的异常免疫反应。小结:虽然甲沟炎被认为是罕见病,但它可能被低估了。单个可见的甲营养不良,尤其是部分甲受累,伴有或不伴有皮疹,应在鉴别中提示LS诊断。眼底镜检查可能有助于更好地观察临床症状。即使在皮损消退后,甲营养不良症的病程也往往会延长。有症状的患者或病情严重、病程较长的甲营养不良患者可选择外用类固醇激素、钙化蛋白抑制剂和类固醇激素鞘内注射。关键信息:(i) 单个指甲受累、指甲变化位于指甲的一个部分以及出现典型的线状带状皮疹应提示 LS 诊断。(ii)甲状镜检查可能有助于更好地观察临床症状,避免不必要的活组织检查。(iii)如果诊断不确定,应进行甲单位活检,以排除指甲受累的更严重和进行性病程,如甲扁平苔藓和/或甲单位肿瘤。