Keratosis Lichenoides Chronica

AKA “lichen ruber acuminatus verrucosus et reticularis”
 
Pathogenesis
  • Unusual form of lichen planus?
 
Clinical presentation
  • Violaceous, keratotic, lichenoid papules
  • Arranged in linear and reticulated pattern
  • Distribution
    • Symmetric
    • Limbs and truck
  • Greasy and scaly eruption in the upper portion of the face
    • Dermatitis or psoriasis like
  • Keratotic papules on palms and soles
 
Prognosis
  • Usually progressive and chronic
  • Occasional regression during summer or with aging
 
Histology
  • Similar to LP
 
Treatment
  • Symptomatic
  • Usually unsatisfactory
  • Topical and systemic corticosteroids
  • MTX
  • Cyclosporin
  • Etretinato / acitretin (nowadays)
  • Oral vitamin A
  • PUVA or re-PUVA