Lichen aureus is a rare skin condition where patches of discoloration appear, usually on the lower limbs. These patches can be yellowish to rust-colored and may be very resistant to treatment in some patients. A dermatologist can evaluate a patient with skin abnormalities to determine their cause and provide treatment recommendations. The best treatment option can depend on the patient's history and the precise nature of the skin problem.
The causes of lichen aureus are not well understood. The growths sometimes develop above a varicose vein or in the wake of trauma, but not necessarily. They may appear in isolation or can multiply in some patients, and tend to concentrate on the lower limbs. The condition is not fatal or dangerous, but can cause social discomfort for patients if the marks are in a prominent location.
If a doctor suspects a patient has this condition, a biopsy may be recommended. The biopsy can check for abnormal cells and cellular changes of concern. It can also help the doctor eliminate alternative diagnoses that might require different treatment approaches. This can usually be done in an office with a quick scraping of the abnormality.
One treatment option is topical steroid medications. The patient may need to take very potent drugs, applied in a cream or ointment to cover the growth. These medications need to be used with care, because they can have serious side effects, including skin thinning. Patients who do not respond to topical steroids may need a different medication, or the doctor could consider abandoning steroid therapy altogether.
Another lichen aureus treatment is psoralens and ultraviolet A (UVA) therapy, known as PUVA. In this therapy, the patient takes medications before a brief session of UVA radiation. Some patients respond very well to PUVA and may experience significant clearing of the lichen aureus rash. Several sessions should determine if the therapy is appropriate for a patient.
Even with treatment, the lichen aureus can return. Patients may develop a chronic skin problem that does not resolve, requiring multiple rounds of treatment to suppress the growth whenever it recurs. In any situation where skin changes become chronic, a doctor may recommend monitoring for cancer, as repeated inflammation and irritation can expose the patient to the risk of skin cancers. The constant sloughing of old skin and development of new skin can increase the chance that a rogue cell will develop and multiply without intervention from the immune system.