cytic atypia


■ Lichen planus-like keratosis is thought to represent the spontaneous involution of a solar lentigo, large cell acanthoma, or reticulated seborrheic keratosis via a cell-mediated immunologic reaction


1. Laur WE, Posey RE, Waller JD. Lichen planus-like keratosis. A clinicohistopathologic correlation. J Am Acad Dermatol 1981; 4:329-336.

2. Goldenhersh MA, Barnhill RL, Rosenbaum HM, Stenn KS. Documented evolution of a solar lentigo into a solitary lichen planus-like keratosis. J Cutan Pathol 1986: 13:308-311.


■ Variants: pigmented purpuric lichenoid dermatosis of Gougerot and Blum

■ Clinically presents as symmetric, bilaterally-distributed, purpuric, and flat-topped papules that coalesce into plaques on the lower extremities

■ Variants: lichen aureus

■ Clinically presents as unilateral group of macules or papules with a rusty, golden color; sites of predilection are the lower extremities and trunk

■ Associated rarely with hepatitis C seropositivity


■ Band-like, mixed infiltrate does not obscure the dermo-epidermal junction (the "noninterface interface" dermatosis) (Fig. 11A)

■ The mixed infiltrate includes variable numbers of extravasated erythrocytes and/or hemosiderin-laden macrophages (siderophages) (Figs. 11B and C)

■ There may also be hemosiderin pigment deposition in the dermis (Fig. 11C)

Differential Diagnosis:


■ Increased capillary fragility, possibly related to venous hypertension, is thought to lead to the extravasation of lymphocytes and erythrocytes from the vessels.


1. Rao BK, Igwegbe I, Wiederkehr M, et al. Gougerot-Blum disease as a manifestation of hepatitis C infection. J Cutan Pathol 2000; 27:569.

2. English J. Lichen aureus. J Am Acad Dermatol 1985; 12:377-378.

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