[Lichen nitidus and lichen striatus]

[Common nail diseases in children and adolescents : Recognize, advise, treat]

There are a number of nail diseases that primarily occur in children and adolescents. Many of these nail changes are physiologic and are only transient. Thus, they do not need any therapy. Infectious nail diseases or nail involvement in chronic inflammatory dermatoses can be found in both children and adults, and may require specific treatment. Nail pigmentation such as longitudinal melanonychia occur significantly less frequently in children than in adult patients, and have different causes and a better prognosis. Knowledge about these child-specific peculiarities of nail diseases is necessary in order to provide the best possible advice to parents and to offer appropriate treatment. This article focuses on the most common and important nail diseases in children and adolescents and their treatment.

Use of H-1 Antihistamine in Dermatology: More than Itch and Urticaria Control: A Systematic Review

H-1 antihistamines are commonly used in dermatological practice for itch and urticaria control. The widespread expression of H-1 receptor on different cells in the skin and various biologic functions of H-1 antihistamines indicate the possible treatment potentials of H-1 antihistamines in dermatology. A literature search was performed on PubMed and Embase, targeting articles reporting use of antihistamine for purposes other than itch and urticaria control in dermatological practice. Several off-label usages of antihistamines were identified, including alopecia, acne, Darier disease, eosinophilic dermatoses, paraneoplastic dermatoses, psoriasis, lichen nitidus, radiation dermatitis, skin dysesthesia, and cutaneous malignancies. Additional benefits were observed when H-1 antihistamines were used either alone or in combination with other therapeutic modalities. Although various novel uses of H-1 antihistamines have been uncovered, the evidence level of most included studies is weak. Further randomized control trials are warranted to better evaluate the efficacy and dosage of H-1 antihistamine for dermatological disorders.

Nail lichen striatus: Is dermoscopy useful for the diagnosis?

BACKGROUND/OBJECTIVES

Lichen striatus is a unilateral inflammatory dermatosis that rarely affects the nail unit. When the inflammation involves the nail unit, classic lichenoid nail changes are easily detectable, more often limited to only one portion of the nail. Usually the nail dystrophy coexists with periungual skin papules following Blaschko's lines, but it could also be an isolated feature. Because a nail unit biopsy presents difficulties in execution, especially in a child, the aim of our study has been to describe the nail unit dermoscopy features of lichen striatus hoping to provide a valid aid to clinicians in the diagnosing this rare disorder.

METHODS

We reviewed the images of five pediatric patients with a clinical diagnosis of lichen striatus. Data about sex, age, localization, predisposing/triggering factors, and associated disorders are reported.

RESULTS

The diagnosis of lichen striatus can be challenging as there are clinically overlapping features with related dermatoses. A common diagnostic pitfall occurs with inflammatory linear verrucous epidermal nevus and lichen planus. Involvement of only one part of the nail plate with linear longitudinal fissuring, ridging, and distal splitting, especially if seen with perionychial skin lesions, is characteristic of lichen striatus.

CONCLUSIONS

Nail lichen striatus is rare, and there is sparse published literature on it. When the changes in lichen striatus are limited to the nail, the diagnosis may easily be missed. We therefore believe that dermoscopy is an important diagnostic maneuver, which should be integrated into the evaluation of patients with potential lichen striatus, and in particular is helpful for clinicians unwilling or unable to perform a nail unit biopsy.