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Skin Care and Diseases

What is lichenoid keratosis

02/08/2002

Question:

i would like to know if someone could explain to me in simple terms, what is lichenoid keratosis?

Answer:

I am not sure that there is a straight forward answer to your question. A keratosis is a patch of skin that has a thick outer layer called the stratum corneum. This outer layer becomes thicker and tends to be dry and scaly. All keratoses have this feature.

If a biopsy were taken from this keratosis, it would have what are called `lichenoid` appearance. That means there are some lymphocytes, i.e., immune cells just below the epidermis, the outer layer of skin. So these lesions are called lichenoid keratoses. The term is a combination of a clinical and histological pattern.

The important question is the biological behavior, i.e., the significance of a lichenoid keratosis. And that is not known. I think that they are just a version of actinic or sun induced keratosis. But that is my interpretation and it might not be correct. Actinic keratoses are no big deal. They indicate sun damage. And only one is 300 become a minor cancer that can be scraped off with no risk to health or life.

I do not believe that any thing need be done to lichenoid keratoses. If they are unattractive, they can be frozen or removed gently by other means. I know of no worrisome outcome or import of these lesions. They probably represent more ignorance and are not worthy of concern.

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Response by:

James J Nordlund, MD
Professor
College of Medicine
University of Cincinnati