Wickham's striae

Wickham's striae are a clinical feature often associated with lichen planus, a common inflammatory skin condition. Named after the British dermatologist Louis Duhring, who first described them in 1895, Wickham's striae appear as fine, white, lacy streaks on the surface of lichen planus lesions.

Clinical Presentation[edit | edit source]

Wickham's striae are most commonly seen in cutaneous lichen planus, but can also be found in other forms of the disease, such as oral lichen planus. They are typically present on the surface of flat-topped, purple papules and plaques. The striae may not be visible to the naked eye, but can often be seen under a dermatoscope.

Pathogenesis[edit | edit source]

The exact cause of Wickham's striae is not fully understood. It is believed that they are the result of changes in the stratum granulosum, the third layer of the epidermis. These changes may include thickening (hypergranulosis) and an accumulation of a substance called hyaline.

Diagnosis[edit | edit source]

The diagnosis of Wickham's striae is primarily clinical, based on the characteristic appearance of the lesions. In some cases, a skin biopsy may be performed to confirm the diagnosis. The presence of Wickham's striae can help differentiate lichen planus from other skin conditions that cause similar lesions, such as psoriasis or discoid lupus erythematosus.

Treatment[edit | edit source]

Treatment of Wickham's striae involves managing the underlying lichen planus. This may include the use of topical corticosteroids, systemic medications, or light therapy (phototherapy). In some cases, the striae may fade as the lichen planus resolves.