A 9-year-old girl is brought by her mother because of the acute onset of a facial rash. There is no associated itching, and the child is, and has been, otherwise healthy.
Key point: The linear arrangement of one or more parallel bands composed of 2 to 4 mm flat-topped papules on the face or on an extremity is classic for lichen striatus. This idiopathic, asymptomatic eruption favors children (4 months to 15 years). Lichen striatus appears abruptly, and after several months to a year, disappears spontaneously.
Treatment: No therapy is generally required. Short-term application of a potent topical steroid will eliminate pruritus, should this be present.
Note: This disorder frequently leaves spots and streaks of post-inflammatory hypopigmentation in children with darker skin tones. This dyschromia usually resolves with time.
