Pediatric emergency medicine trisk 1373 1373
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FIGURE 70.14 Inflammatory linear verrucous epidermal nevi (ILVEN). ILVEN is
notable for its often larger collections of verrucous plaques with background
inflammation.
Since lichen striatus resolves spontaneously in most typical cases, no
treatment is necessary. In those with symptomatic pruritus, topical steroids
may be considered for intermittent use.
VIRAL SYNDROMES
Viruses are involved as the presumed cause or trigger for a variety of
patterned skin disorders. Their specific identification is not always possible
in fully developed presentations, and this can be frustrating even for
seasoned clinicians. The difficulty in diagnosis is accentuated in the earliest
stages of the viral syndromes when the patterns may not yet be fully
established. Unfortunately, these patients tend to present much earlier in the
course of the disease to the emergency department than to dermatology.
Typically, these syndromes arise either during the acute phase of the disease
(as with Kaposi varicelliform eruption [KVE]), or as a reactive phenomenon
as the viral infection resolves (as with papular-purpuric gloves-and-socks
eruption [PPGS], unilateral laterothoracic exanthem [ULE], and Gianotti–
Crosti syndrome [GCS]).
