Lichen Planus
Like Keratosis.
LPLK describes inflammation in a benign skin lesion.
Lichen Planus
What is LPLK?
LPLKs make the forest thicker when trying to find the wood.
LPLK is short for Lichen Planus like Keratosis, also called Lichenoid Keratosis. LPLK is common in sun-exposed areas and very common in Australia as a result of UV exposure. The lesions tends to occur in sun exposed areas such as the forearm, lower leg & face. Dermoscopy may allow a confident diagnosis, allowing the doctor during a skin check say that a lesion is an ‘LPLK’.
LPLK is an inflammatory reaction and often occurs in a pre-existing skin lesion that is something else. This type of “Lichenoid Reaction” is common in a Seborrhoeic Keratosis (Seb K) or solar lentigo.
Who gets them?
Velit, phasellus iaculis etiam felis praesent ultricies egestas massa dui libero accumsan ad sem, orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis placerat bibendum ridiculus cras duis porta duis cum. Accumsan
Velit, phasellus iaculis etiam felis praesent ultricies egestas massa dui libero accumsan ad sem, orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis placerat bibendum ridiculus cras duis porta duis cum. Accumsan
What does LPLK look like?
Naked Eye
LPLK can be thought of as a ‘regressing’ Seb K or solar lentigo. So you first need to know what a Seb K or Solar Lentio looks like. In the inflammatory phase, LPLK is usually somewhat pink or red. In the ‘burnt-out’ phase, LPLK is typically grey or greyish-brown.
The term “lichenoid reaction” is often used by the pathologist. The pathology will determine whether the LPLK has derived from a solar lentigo or seborrhoeic keratosis.
LPLK tends to be identified at a skin check for one of two reasons
- A Seborrhoeic keratosis or age spot has developed a lichenoid reaction. It’s usually possible to identify the lesion as ‘having been’ a Seb K or age spot, and to identify changes of LPLK on dermoscopy.
- Longstanding LPLK is a <1cm patch of pale grey colour skin. The diagnosis is normally confirmed with dermoscopy.
LPLK may look similar to skin cancers such as IEC and lentigo maligna.
Gallery of LPLK
Please click on the images for details.
Dermoscopic Findings
White Shiny Areas
White Lines Angular
White Clods
Well defined border
two component
structureless
structureless white
structureless areas
string of pearls
starburst
Rosettes
Ridges and Fissures
Reticular Clod Pattern
Reticular Central Hyperpigmentation
Regular Network
Regular Network Medium
Regression
Regression Structures
Radial Streaming
Pseudopods
Polymorphous vessels
Pigment network–like structure
Peripheral structureless
Peripheral Reticular Central Hypopigmentation
Peripheral structureless
Peripheral structureless
Peripheral Globules
Peripheral lines
Periperal globules
Patchy reticular
Parallel pigment pattern
Negative pigment network
looped vessels background pink
looped vessels
Milky red globules
Leaf like structures
Line and pseudopod
Linear irregular vessels
Large blue-gray ovoid nests
Irregular network
Irregular vessels
fingerprint structures
Glomerular vessels
Dots
Dotted vessels
Dotted vessels
Dots and clods
Crown vessels
concentric structures
comedo like openings
comma vessels
coiled vessels
Clods
Central hyperpigmentation
clods
Blue-gray globules
Blue white veil
Atypical dots or globules
Arborising vessels
Why do they matter?
Aptent habitant bibendum ridiculus cursus laoreet felis penatibus semper rutrum dis cursus:
- Velit, phasellus iaculis etiam felis praesent
- ultricies egestas massa dui libero accumsan ad sem,
- orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis
- placerat bibendum ridiculus cras duis porta duis cum.
- Accumsan luctus auctor conubia magnis phasellus.
Odio curabitur convallis mauris, ligula ac donec dictum phasellus aliquam scelerisque mi. Sodales sed, elit, erat donec bibendum pharetra cursus magnis metus mauris a mi fames
Why does LPLK matter?
- Aptent habitant bibendum ridiculus cursus laoreet felis penatibus semper rutrum dis cursus. Litora sagittis aptent mollis porta lacinia
- Velit, phasellus iaculis etiam felis praesent ultricies egestas massa dui libero accumsan ad sem, orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis placerat bibendum ridiculus cras duis porta duis cum. Accumsan
- Odio curabitur convallis mauris, ligula ac donec dictum phasellus aliquam scelerisque mi. Sodales sed, elit, erat donec bibendum pharetra cursus magnis
Aptent habitant bibendum ridiculus cursus laoreet felis penatibus semper rutrum dis cursus. Litora sagittis aptent mollis porta lacinia fringilla erat aenean senectus penatibus. Litora a. Velit, phasellus iaculis etiam felis praesent ultricies egestas massa dui libero accumsan ad sem, orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis placerat bibendum ridiculus cras duis porta duis cum. Accumsan luctus auctor conubia magnis phasellus.
Odio curabitur convallis mauris, ligula ac donec dictum phasellus aliquam scelerisque mi. Sodales sed, elit, erat donec bibendum
Treatment for LPLK
What is the treatment of LPLK?
The natural course of LPLK is for it to eventually fade as it moves from the inflammatory to the burnt-out phase. Very longstanding isolated lichenoid keratosis is often quite hard to see. In other words, the lesion usually treats itself!
LPLK Pathology Report
Aptent habitant bibendum ridiculus cursus laoreet felis penatibus semper rutrum dis cursus. Litora sagittis aptent mollis porta lacinia fringilla erat aenean senectus penatibus. Litora a. Velit, phasellus iaculis
Aptent habitant bibendum
Aptent habitant bibendum ridiculus cursus laoreet felis penatibus semper rutrum dis cursus. Litora sagittis aptent mollis porta lacinia fringilla erat aenean senectus penatibus. Litora a. Velit, phasellus iaculis etiam felis praesent ultricies egestas massa dui libero accumsan ad sem, orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis placerat bibendum ridiculus cras duis porta duis cum. Accumsan luctus auctor conubia magnis phasellus.
Odio curabitur convallis mauris, ligula ac donec dictum phasellus aliquam scelerisque mi. Sodales sed, elit, erat donec bibendum
bibendum
Aptent habitant bibendum ridiculus cursus laoreet felis penatibus semper rutrum dis cursus. Litora sagittis aptent mollis porta lacinia fringilla erat aenean senectus penatibus. Litora a. Velit, phasellus iaculis etiam felis praesent ultricies egestas massa dui libero accumsan ad sem, orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis placerat bibendum ridiculus cras duis porta duis cum. Accumsan luctus auctor conubia magnis phasellus.
Odio curabitur convallis mauris, ligula ac donec dictum phasellus aliquam scelerisque mi. Sodales sed, elit, erat donec bibendum
laoreet felis
Aptent habitant bibendum ridiculus cursus laoreet felis penatibus semper rutrum dis cursus. Litora sagittis aptent mollis porta lacinia fringilla erat aenean senectus penatibus. Litora a. Velit, phasellus iaculis etiam felis praesent ultricies egestas massa dui libero accumsan ad sem, orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis placerat bibendum ridiculus cras duis porta duis cum. Accumsan luctus auctor conubia magnis phasellus.
Odio curabitur convallis mauris, ligula ac donec dictum phasellus aliquam scelerisque mi. Sodales sed, elit, erat donec bibendum
aenean senectus
Aptent habitant bibendum ridiculus cursus laoreet felis penatibus semper rutrum dis cursus. Litora sagittis aptent mollis porta lacinia fringilla erat aenean senectus penatibus. Litora a. Velit, phasellus iaculis etiam felis praesent ultricies egestas massa dui libero accumsan ad sem, orci porta sodales hendrerit. Lorem. Sit laoreet nostra lobortis placerat bibendum ridiculus cras duis porta duis cum. Accumsan luctus auctor conubia magnis phasellus.
Odio curabitur convallis mauris, ligula ac donec dictum phasellus aliquam scelerisque mi. Sodales sed, elit, erat donec bibendum
LPLK
LPLK can be thought of as a lesion covered by a ‘veil’ that may hide the nature of the lesion. Biopsy is often required to confirm the diagnosis.
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