Lichen Planuslike Keratosis

Synonyms: Benign lichenoid keratosis; solitary lichenoid keratosis solitary lichen planus.

Clinical Presentation:

■ Present as a solitary, violaceous, slightly scaly papule, or plaque of apparently acute onset, usually on the upper trunk or proximal upper extremities in adults between the ages 40 and 70

Histology:

■ Focal-to-prominent parakeratosis (Fig. 10B)

■ Wedge-shaped hypergranulosis (Fig. 10A)

■ Jagged, "saw-tooth" acanthosis of the epidermis (Fig. 10A)

■ Band-like, superficial lymphocytic infiltrate which obscures the dermoepidermal junction (Fig. 10A)

■ Necrotic keratinocytes scattered throughout the epidermis

■ There may be a residual solar lentigo at the edge of the lesion (Fig. 10C).

■ Keratinocytic atypia is minimal or absent

Differential Diagnosis:

Lichen Planus-Like

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