Successful treatment of lichen spinulosis with topical roflumilast: A case report

Lichen spinulosis is an uncommon, follicular keratotic disorder characterized by asymptomatic clusters of follicular papules with keratotic spines that primarily occurs in children, and rarely in adults. Various treatment options have been reported in the literature, although none are universally effective. Topical roflumilast (0.3%) is a recently approved phosphodiesterase-4 inhibitor first used in psoriasis which has shown reduction in hyperkeratosis in vitro. We report on an adult with symptomatic and recalcitrant lichen spinulosis who achieved significant improvement with the use of topical roflumilast over a 6-month period.