Cryotherapy for Lichen Striatus in an Adult – a Case Report

Lichen striatus (linear lichenoid dermatosis) is an uncommon, self-limited, inflammatory, linear skin condition of unknown origin. The causes of linear distribution are unknown, though the pattern of lichen striatus (LS) mostly follows the lines of Blaschko (BL). The condition most commonly occurs in children between 5 and 15 years of age, usually after the first year of life.

We report a 27-year-old, otherwise healthy flight attendant with LS whose diagnosis was based on: the history of sudden appearance and rapid linear spread of lesions; clinical presentation of small pink, coalescing scaly papules without umbilication or Wickham’s striae, linear distribution following one BL down a lower limb to the ankle, with a band broadening into plaque on the left buttock; histology showed some hyperkeratosis, lichenoid dermatitis similar to lichen planus, but with the presence of inflammatory infiltrate in the papillary dermis and also deeper in the perifollicular region. The inflammatory infiltrate consisted mainly of limphocytes, with some melanophages and histiocytes.

There is no standard treatment for LS, and it is given for cosmetic or psychological reasons only, as we have done in our patient due to slight pruritus and occupational reasons. With regard to her occupational demands, in order to achieve satisfying results, she was successfully treated with cryotherapy, which she tolerated well, without any side effects. Cryotherapy was performed twice, with a two-week interval. Full resolution was achieved twelve weeks after cryotherapy.

In conclusion, we present an adult female who developed lichen striatus suddenly three months after delivery and was successfully treated with cryotherapy.