[Lichen striatus with nail dystrophy in an infant]

Area of Science:

• Dermatology
• Pediatric Dermatology
• Pathology

Background:

• Lichen striatus is an acquired skin eruption typically seen in children aged 3-10 years, characterized by linear patterns along Blaschko's lines.
• Nail involvement in lichen striatus is uncommon, with few cases reported in medical literature.
• This report details a rare instance of lichen striatus with significant nail involvement in an infant.

Observation:

• A 10-month-old boy presented with acquired onychodystrophy affecting the third and fourth fingers, showing longitudinal ridging and splitting.
• Physical examination revealed linear bands of pink papules on the fingers, consistent with lichen striatus.
• Skin biopsy confirmed lichen striatus with a lymphocytic infiltrate and exocytosis.

Findings:

• The infant's skin and nail lesions resolved spontaneously within 9 months.
• This case represents the youngest patient reported with lichen striatus and nail involvement.
• Common clinical features of nail involvement include longitudinal ridging, splitting, thinning, and onychodystrophy.

Implications:

• This case expands the known age range for lichen striatus with nail involvement.
• It underscores the importance of considering lichen striatus in the differential diagnosis of pediatric onychodystrophy.
• Early diagnosis and recognition of nail changes in lichen striatus are crucial for understanding its clinical spectrum.