European Journal of Biomedical and Pharmaceutical Sciences

DIAGNOSTIC ERRORS IN LICHEN STRIATUS: THE IMPACT OF IRRATIONAL USE OF ANTIFUNGALS

*M. in C. Jorge Rafael Figueroa Morales, Dr. J. Ascención Montalvo González, M. in C. Isaac Espinosa Santana and Dr. Eduardo Mendeleev Becerra Verdín

ABSTRACT

Lichen striatus is a rare inflammatory dermatosis characterized by the appearance of linear papules that follow Blaschko's lines. Although it can affect any age group, it is more common in children between 5 and 15 years old. Its etiology is uncertain, although it is associated with genetic, autoimmune and infectious factors. Clinically, it presents with erythematous or hypopigmented papules, with a slightly raised texture, arranged in a unilateral linear pattern. The lesions are usually asymptomatic or slightly pruritic and evolve in a self-limiting manner over a period of 6 to 24 months. The diagnosis is mainly clinical, but in atypical cases a skin biopsy may be required. The differential diagnosis includes linear lichen planus, incontinence pigmenti, linear inflammatory nevus, cutaneous lupus erythematosus, linear psoriasis, vitiligo, and pityriasis lichenoides chronica. Histopathology shows a band lymphocytic infiltrate in the superficial dermis. Treatment is conservative due to its self-limiting course. In symptomatic cases, topical corticosteroids, calcineurin inhibitors, emollients, oral antihistamines and, in refractory situations, phototherapy can be used. Educating caregivers about the benign nature of lichen striatus is essential to avoid unnecessary interventions. This case highlights the importance of an accurate differential diagnosis in pediatric dermatology to prevent the irrational use of topical treatments, such as antifungals, and reduce diagnostic errors. Continuous training of health professionals and the use of complementary diagnostic tools is recommended to improve care for these conditions.

Keywords: Lichen striatus, treatment, irrational use.