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])