An Unusual Rash in a Five-Year-Old Girl: Blaschkoid Distribution Is the Key to the Diagnosis

Lichen striatus is a rare dermatological condition seen in children. The exact etiology of this self-limiting eruption is unknown. A combination of genetic predisposition with an infectious trigger is the most accepted hypothesis for the etiology. Treatment is typically not necessary, as the disease is self-limiting. Treatment options with topical low to mid-potency corticosteroids may be used for symptomatic treatment of pruritus, however, it does not alter the course of the disease or post-inflammatory dyspigmentation. Successful treatment of skin lesions with calcineurin inhibitors is reported in isolated studies. The rapidly growing lesion of lichen striatus can cause considerable parental anxiety. Familiarity with this condition for primary care pediatricians is necessary to make the correct diagnosis and to alleviate parental anxiety. Here, we present a case of lichen striatus albus, a variant of lichen striatus, in a five-year-old girl presenting as a skin rash.