A study of dermoscopic patterns of Wickham's striae in lichen planus


  • Nandini A. S. Department of Dermatology, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India
  • Mariet Zacharias Department of Dermatology, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India




Lichen planus, Dermoscopy, Wickham’s striae


Background: Wickham striae corresponds to fine white or gray lines or dots seen on the top of the papular rash and oral mucosal lesions of lichen planus. The documented types of Wickham’s striae dermoscopic patterns are linear, reticular, circular, globular, star-burst, radial and leaf-like. Aim was to study and describe the dermoscopic patterns of Wickham’s striae in lichen planus.

Methods: A prospective study was conducted between December 2019 to March 2020, among outpatients in the department of dermatology, venereology and leprosy in a tertiary care hospital. The lichen planus lesions including Wickham striae pattern were visualised with the dermatoscope (DermLite DL 4) and documented.

Results: The 20% had the circular pattern, 10% radial streaming, 4% leaf venation and 2% starry sky appearance. Other pattern observed were linear which was seen in 6% of the patients. They were seen associated with lesions over the lip. Vascular patterns were noted only in 20% of the patients with most of them having dotted patchy type of vessels.

Conclusions: With dermoscopy, the Wickham’s striae are the diagnostic key to differentiate lichen planus from other papulosquamous disorders. In our study we were able to see various patterns of Wickham’s striae including a less reported form like leaf venation.


James WD, Berger TG, Elston DM. Andrews Diseases of the skin: clinical dermatology. 12th ed. Vol 1. Philadelphia, PA: Elsevier. 2016;201.

Steffen C, Dupree ML. Louis-Frédéric Wickham and the Wickham's striae of lichen planus. Skinmed. 2004;3:287-9.

Sachdeva S, Sachdeva S, Kapoor P. Wickham striae: etiopathogenensis and clinical significance. Indian J Dermatol. 2011;56(4):442-3.

Vázquez-López F, Alvarez-Cuesta C, Hidalgo-García Y, Pérez-Oliva N. The handheld dermatoscope improves the recognition of Wickham striae and capillaries in Lichen planus lesions. Arch Dermatol. 2001;137(10):1376.

Friedman P, Sabban EC, Marcucci C. Dermoscopic findings in different clinical variants of lichen planus. Is dermoscopy useful? Dermatol Pract Concept. 2015;5(4):51-5.

Makhecha M, Singh T, Malladi N, Rambhia K. Dermoscopic features of various stages of lichen planus. Indian J Dermatol Venereol Leprol. 2020;86:191-4.

Güngör Ş, Topal IO, Göncü EK. Dermoscopic patterns in active and regressive lichen planus and lichen planus variants: A morphological study. Dermatol Pract Concept. 2015;5:45-53.

Lallas A, Argenziano G. Dermatoscope-the dermatologist’s stethoscope. Indian J Dermatol Venereol Leprol. 2014;80(6):493-94.

Rivers JK, Jackson R, Orizaga M. Who was Wickham and what are his striae? Int J Dermatol. 1986;25:611-3.

Summerly R, Wilson Jones E. The Microarchitecture of Wickham's Stirae. Trans St. Jhon's Hosp Dermatol Soc. 1964;50:157-61.

Ryan TJ. The direction of the growth of the epithelium. Br J Dermatol. 1966;78:403-15.

Tan C, Min ZS, Xue Y, Zhu WY. Spectrum of dermoscopic patterns in lichen planus: a case series from China. J Cutan Med Surg. 2014:18(1):28-32.

Litaiem N, Mansour Y, Jones M. Dermoscopic signs of lichen planus. Case Rep. 2016;2016:bcr2015213923.






Original Research Articles