Ichenoid Keratosis
Cary Chisholm, MD
Key Facts
Terminology
Benign lichenoid keratosis (BLK), lichen planus-like keratosis (LPLK), involuting lichenoid plaque, solitary lichen planus
Clinical Issues
Upper extremities and trunk
Solitary circumscribed papule or plaque up to 1 cm in diameter
Erythematous or violaceous ± scale
Pruritus &/or burning sensation
Microscopic Pathology
Characterized by dense lichenoid band of predominantly lymphocytes and histiocytes
Usually acanthotic with scattered apoptotic keratinocytes
Interface vacuolar change, Civatte bodies, and pigment incontinence
Hyperkeratosis with orthokeratosis or parakeratosis
 Biopsy-proven lichenoid keratosis presented as a keratotic, light pink, 1 cm plaque on the breast of this female patient. |
 Lichenoid keratosis is characterized by a single lesion with a lichenoid lymphocytic infiltrate. |
TERMINOLOGY
Synonyms
Benign lichenoid keratosis (BLK), lichen planus-like keratosis (LPLK), involuting lichenoid plaque, solitary lichen planus
Definitions
Keratosis with a lichenoid band of inflammation
ETIOLOGY/PATHOGENESIS
Reactive Condition
Preexisting lesion usually present
e.g., solar lentigo or seborrheic keratosis
Sensitization to lesion occurs
Body mounts immune response to attack lesion
Biopsy occurs after immune-mediated destruction has started
Original lesion may or may not be discernible
CLINICAL ISSUES
Epidemiology
Age
Middle-aged and older adults
Gender
More common in females
Site
Upper extremities and trunk
Presentation
Solitary circumscribed papule or plaque up to 1 cm in diameter
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