What is Lichenoid Keratosis?
Lichenoid Keratosis is benign skin condition which causes skin lesions that are non-cancerous, and their color ranges from red to gray. They are most common among women and people with lighter skin color in comparison to others. They look similar to freckles (also known as solar lentigo) and usually appear on the hands, arms or chest.
The condition is asymptomatic except for the appearance of the lesion itself which makes the diagnosis difficult. Lichenoid keratosis is not a communicable disease, and no specific food causes such an effect. Other terms used for this skin problem are lichen planus like keratosis, benign lichenoid keratosis, etc.
Image Source: Dermnetnz.org
Features
- Asymptomatic lesion that is solitary
- Most often, the lesions appear on the arms, chest & hands and sometimes isolated lesions may appear on the face and neck as well
- Lesions are small and do not exceed 1 cm. They are linear, warty and small elevations on the skin.
- Color of the lesion depends on how rapidly it develops; it grows darker with time
- Surface and texture may be smooth or scaly
- Occasional experience of mild itching or a stinging sensation may occur
- Lesion mostly appears in old and middle-aged individuals
Causes
- Build up of dead keratin cells: Keratin is a protein that makes up most of the hair, nails, skin and tooth enamel. As time passes, the body pushes protein towards the surface of the skin and the protein dies. When these dead proteins accumulate, they result in the development of hard and scaly lesions. Usually, the dead keratin protects the live cells present under them, but when there is excessive build up, they may lead to lichenoid keratosis.
- Exposure to the sun: Overexposure or unprotected exposure to the sun could cause lichenoid keratosis within three months. Another possibility is that an already existing skin condition.
Risks
People who are more prone to suffer from lichenoid keratosis include:
- Skin tanning due to use of devices such as tanning beds
- Caucasians are more likely to develop this condition in comparison to people with darker skin tones
- Commonly seen in adults between the age groups of 30 to 80 years
- Affects females more than men
Complications
- Cosmetic concern: These lesions may seem like blemishes on the skin. Moreover, they appear in areas that are visible to others and exposed to the sun such as the neck, chest, arms and face. It may result in a decrease in self-confidence and may bother the individual.
- Psychological stress: Sometimes, the lesions tend to resemble cancerous tumors and may be a reason behind psychological stress among people anticipating the effects of cancer.
Diagnosis
- Complete physical examination
- Evaluation of the individual’s medical history
- Wood lamp examination of the skin using ultraviolet light to observe the change in skin pigmentation
- Skin biopsy for pathological examination
- Dermoscopy – to check whether the skin growth is malignant or benign
Prevention
Doctors have not been able to develop medications that could help to prevent lichenoid keratosis, as of yet. However, the best possible method available is to restrict the time spent under the sun. The harmful effects of the ultraviolet rays are thought to be a major cause of this condition. Therefore, following this measure may reduce chances of lichenoid keratosis considerably.
Treatment
- Medication: Topical and systemic corticosteroids are effective in treating lichenoid keratosis.
- Methotrexate can slow down the rapid growth of cells
- Cyclosporine suppresses the responses of the immune system
- Etretinate treats psoriasis
- Treatment: Liquid nitrogen and curettage is the treatment that the surgeon uses to remove the lesions. The lesion is made loose using liquid nitrogen and scrapping it with the help of an instrument. Laser technology or electrosurgery can also be used to perform the removal.
When to visit a Doctor?
The diagnosis for lechanoid keratosis is very difficult. Therefore, it is important to visit a doctor as soon as the symptoms are experienced. It allows correct examination and treatment on time.
