Causes Of Lichenoid Keratosis: Clinical Features And Treatment

When we talk about Lichenoid keratosis, we are dealing with a skin problem. Lichenoid keratosis is small skin lesion that usually appears on the arm, hands and the chest. Lichen kerotosis is usually a solitary lesion which appears similar to a solar lentigo (freckles). It is easy to recognize lichenoid keratosis lesion from its red to grey color. This is a benign skin condition and it is referred by many other names such as benign lichenoid keratosis, lichen planus like keratosis etc.

Lichenoid keratosis is usually asymptomatic except for the lesion itself.

It is not a common skin lesion and therefore many patients miss it. Usually the lesion is identified by the physician who performs careful skin examination. Lichen keratosis is treated by applying topical steroidal cream. Electrosurgery, use of liquid nitrogen and surgical removal are other treatment procedures for lichenoid keratosis.

What Causes Lichenoid Keratosis?

Keratin is a type of protein which is present abundantly in hair, nail, and enamel of tooth. Keratin is also present in skin. Normally, keratin dies and is shed off from the skin surface as new skin cells develop.

However, in some cases there is build up of keratin on the upper surface of skin which changes into hard scaly lesion. This lesion is called lichenoid keratosis. The name lichen is derived from an alga found widely on diverse habitats such as rock surface, trees etc. The lesion looks similar to lichen hence the name lichenoid keratosis.

The exact cause of this skin condition is not known, but it is believed to arise from lentigos. That is why this lesion is frequently seen on exposed areas to sunlight. Women are more affected than men. Lichenoid keratosis is more common among whites, especially Caucasians. The lesion is rarely observed among Asians and Africans.

Lichenoid Keratosis Clinical Features

Usually lichenoid keratosis is asymptomatic lesion. In majority of cases it is a solitary lesion. Sometimes there may be associated one or two lesions on other parts. The lesions of Lichenoid keratosis are frequently seen on arms, hands and chest. Sometimes an isolated lesion is found on face and head or on the neck along with arms or the chest.

The lesion is small in size and it hardly enlarges more than 1 cm. The color of lesion depends on its rapidity of development. If it is less than 3 months the color is red or pink is color. If the lesion is since one year, it becomes darker in shade and turns brown. Chronic lesions appear grey or dark brown.

The surface and texture may vary. Some may be smooth while others may be scaly. Occasionally patients may have mild itching or stinging sensation. Most lesions appear in middle aged and elderly individuals.

Treatment For Lichenoid Keratosis

Before diagnosing lichenoid keratosis, it is necessary to differentiate it from other skin lesions which may cancerous. A dermatologist therefore performs skin biopsy to rule out other dangerous causes. Sometimes the doctor recommends complete excision of the lesion if it is too small for the biopsy. Once the histopathology is confirmed under microscope, several treatment measures can be tried.

Topical application of steroid cream has proved effective in eradicating the lesion. Liquid nitrogen, electrosurgery and complete surgical removal are other options.

Certain home remedies may also be effective, but it may take long time to heal the condition. Local application of aloe vera gel or castor oil may be beneficial sometime.

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