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Lichen striatus is a self-limiting condition which lasts 6 to 12 mo on average and does not typically recur.1 Up to half of cases resolve with postinflammatory hypopigmentation, but this too improves spontaneously and lesions heal without scarring.2 Treatment and laboratory work-up are generally unnecessary. Mild to medium potency topical corticosteroids may be considered as a first-line therapy for symptomatic control of itch.1 Accelerated resolution of signs and symptoms of disease has been reported with combination therapy of topical corticosteroid plus retinoid.3 Topical calcineurin inhibitors are also effective for cases that are refractory to topical corticosteroids, and for lesions involving sites such as the face where steroid-sparing agents are preferred.4-6 For patients with nail involvement, combination therapy with intralesional triamcinolone (5 mg/mL) plus topical corticosteroids or calcineurin inhibitors can be of benefit.7 Oral antihistamines should be considered in cases associated with generalized pruritus or sleep disruption. See Table 14-1.
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