skip to main content

Lichen Striatus — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardPaediatric DermatologyLichen StriatusSCE Dermatology

A 15-year-old develops an acquired unilateral band of erythematous papules along a Blaschko line on the arm. Biopsy shows focal spongiosis with a lichenoid infiltrate involving eccrine structures and hair follicles. The eruption begins to fade over subsequent months. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Lichen striatus, an acquired self-limiting Blaschko-linear eruption

Explanation lettering: C = shown as A · E = shown as C · A = shown as D · D = shown as E

A is correct. Lichen striatus is an acquired Blaschko-linear eruption in children and adolescents. Its mixed spongiotic and lichenoid pattern, with inflammation around adnexal structures, supports the diagnosis; spontaneous fading over months is also characteristic. B commonly begins earlier and remains intensely pruritic, verrucous and persistent. C has a cornoid lamella and a clinically keratotic border. D is typically more violaceous and may accompany lichen planus elsewhere. E shows psoriasiform histology with neutrophils and persistent scale.

Reference: DermNet lichen striatus review: https://dermnetnz.org/topics/lichen-striatus