Benign lichenoid keratosis

Forty patients (39 white, one Oriental) had an isolated asymptomatic lichenoid keratotic lesion varying from bright red to violaceous to brown. The clinical diagnoses included basal cell carcinoma, actinic keratosis, Bowen's disease, and seborrheic keratosis. Histologically, lichenoid features prevailed, often indistinguishable from those of lichen planus. Although the majority of lesions occurred in sun-exposed skin and showed histologic evidence of solar elastosis, changes typical of carcinoma in situ were absent. The correct pathologic diagnosis of benign lichenoid keratosis was initially made in only seven cases.