Lichenoid Keratosis

What is lichenoid keratosis?
Lichenoid keratosis, also known as, keratosis lichenoides chronica is a condition where, usually, a solitary brown lesion turns red and becomes itchy. These lesions usually appear in an area that is exposed to the sun. They generally appear most on the forearms, hands or chest of middle aged white women. These lesions are commonly biopsied because of their similarity to basal cell carcinoma.

What are the symptoms of lichenoid keratosis?

  • Linear, warty, small elevation on the skin
  • Solitary brown lesions that turn red and become itchy
  • Most appear on the forearms, hands and chest of middle aged women
  • Usually appearing in areas that are exposed to the sun

What treatments are available for this condition?
Although there are treatments available they are usually unsatisfactory.  The following are some treatments available:

  • Topical and systemic corticosteroids
  • Methotrexate slows the growth of rapidly growing cells
  • Cyclosporine suppresses the immune systems responses
  • Etretinate

What else should I know about this condition?
There are many other conditions that can have the appearance of solitary brown or red lesions.  Therefore, it is vitally important to see a doctor at Cleaver Dermatology as soon as possible to rule out any other conditions.  Other skin conditions to consider are:

  • Bowen's disease (carcinoma) is usually solitary and may be red-brown in color. A lesion caused by Bowen's disease has an irregular surface, scalloped margins, and a minimally atrophic center.
  • Tinea corporis (ringworm fungus) can be solitary and is scaly and red or brown. Unlike the plaque seen in this case, a tinea corporis lesion is typically ring shaped and characterized by an advancing border and central clearing.
  • Nevi (moles) can start out as brown papules and become irritated and red following minor trauma. Moles are seldom larger than 1 cm in diameter, however, tend to disappear after age 65.

After careful analysis and a possible biopsy, Dr. Cleaver may be able to identify your condition as benign lichenoid keratosis, which is essentially a seborrheic keratosis that has become inflamed. The combination of the original brown color of the lesion and red (a color characteristic of inflammation) affirms this diagnosis.