Linear lesions in Dermatology : a clinico-etio-pathological study.

Linear lesions are fairly common in our day to day practice. However, the appearances can be deceptive which puts dermatologists in a diagnostic dilemma.To study the various clinical presentations, demographic profile of patients and clinico-pathological correlations of dermatoses presenting with a linear distribution.We conducted an institution based cross-sectional, descriptive study on 281 consecutive patients with linear lesions, attending the Dermatology clinic. MedCalc version 11.6 software was used for statistical analysis.Patients were divided into eight groups : lesions along Blaschko's lines(n=136), along blood vessels(n=3), along lymphatics(n=3), koebner's phenomenon(n=24), autoinoculation(n=24), external factors(n=45), infestations(n=2) and others(n=44). Mean age at presentation was 24.50±18.82 years. Male:female ratio was 1.32:1. Commonest complaints were itching/burning in 56.94% patients. Commonest site was upper limb (44.48%); followed by lower limb(30.60%), trunk and abdomen(22.42%), head and neck(19.20%) and genitalia(0.35%). Apart from the common cases, we came across a wide gamut of rare conditions (angiokeratoma circumscriptum neviforme, porokeratotic eccrine ostial and dermal duct nevus, blaschko-linear syringocystadenoma papilliferum, progressive cribriform and zosteriform hyperpigmentation, unilateral nevoid acanthosis nigricans, fixed drug eruption, discoid lupus erythematosus etc.) CONCLUSION: Linear lesions act as diagnostic clues in many dermatological conditions. Therefore, the importance of meticulous examination in clinical dermatology cannot be overemphasized.

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Authors: A Das, S Mohanty, R C Gharami, S N Chowdhury, P Kumar, N K Das, D Bandyopadhay