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What Is Lichenoid Keratosis?

By Christina Edwards
Updated May 17, 2024
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Lichenoid keratosis refers to a type of small benign skin lesion. Other than the lesion on the skin, there are very few symptoms of this disorder. This lesion, sometimes referred to as a papule, can range from red to gray in color. Some people, like females or the elderly, seem to be more at risk of developing this type of lesion than others. Treatment for this condition may include medicated creams or surgery.

Keratin is a protein in the body that makes up much of a person's hair, skin, and nails. It can also be found in tooth enamel. As this protein is pushed to the surface of the skin on a person's body, it dies. A buildup of these excess dead keratin cells can lead to a hard or scaly lesion on the body. When this happens, it can resemble lichen, a type of crusty fungus that can often be found growing on rocks and trees.

There are often very few reported symptoms of lichenoid keratosis. Some individuals may report an itchy feeling, and a few may feel a slight stinging sensation. The skin lesion is typically the most common, and sometimes the only, reported symptom.

Lesions associated with lichenoid keratosis are typically quite small. On average, they will usually grow to be no larger than a 0.5 inch to 1 inch (1.3 to 2.5 centimeters). These lesions also have a tendency to form on areas that are frequently exposed to sunlight. They can often be found on a person's torso or arms. In some cases, they can be found on the head, face, or neck. Usually only one of these lesions will appear on a person's body, but a few people may have a couple more.

Skin lesions caused by this condition can vary in color. Many of them may first appear red or pink. Others may be violet, brown, or gray. They can also vary in texture. Some of them may be relatively smooth, for instance, while others may be scaly.

Females are typically more at risk of developing lichenoid keratosis. In fact, some studies show that women are more than twice as likely to get these types of lesions. This skin disorder almost always affects fair skinned and older people.

Lichenoid keratosis treatment typically begins with a medicated topical cream containing corticosteroids. They can also be covered with liquid nitrogen. In a few cases, surgical removal of the lesion may be necessary.

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Discussion Comments

By anon1000257 — On Jul 26, 2018

Has anyone had these suddenly appear and resemble a bite, like maybe a spider bite? I have two on my shin that appeared overnight, and when I got them checked out, I was prescribed an antibiotic although the source was undetermined. Was told I might need a test for Lyme disease in a few weeks just in case it was a deer tick bite. But now I'm wondering if they are simply lichenoid keratosis (after all, I'm 53, and it seems most common among middle-aged women). Was proofreading my medical transcription practice and came across this term!

By anon998662 — On Jul 27, 2017

My dermatologist just told me that the places on my body are Lichenoid Keratosis. I have them on my legs mostly but also 2 on my back and 1 on the back of my arm above my elbow. She said they are hereditary. She froze 1 on my back today. I have also had a little success using Freeze off on a few of them.

By anon991588 — On Jul 02, 2015

I had a biopsy done on my leg and the result was lichenoid keratosis, so I am also proof that it can and does appear on legs. They first tried a cream to treat it with no success so the biopsy was performed. Now I have a big red hole that resembles a cigarette burn. I can live with that.

By anon959283 — On Jul 03, 2014

I've just been diagnosed. I was a bit bothered at first as no one mentioned the leg as an affected area. It's a relief to find a report from somebody else who has affected legs. Thanks. All your comments are much appreciated.

By browncoat — On May 12, 2013

It's kind of weird how little science seems to know about the skin. Stuff like this will happen, and even though they kind of understand the mechanics of it, they don't really know how to stop it from happening, or why it happens to this person and not their sister.

I think I've got a couple of these, although they might be moles (I've always had them and I'm not worried enough about them to get them checked out).

By pastanaga — On May 11, 2013

@umbra21 - Well, they can actually get fairly big if you see the pictures online. I had a friend with these on her legs and they embarrassed her so much. She really wanted to get rid of them and tried all the creams, but it didn't work.

Her parents didn't want her to have surgery until she was older, which she found to be tyrannical, but I could see their point.

It was kind of sad though, because she never wore shorts and never went swimming and basically just felt bad about herself all the time, even though it's not like she could help having it.

By umbra21 — On May 11, 2013

They essentially look like a very large freckle. I've got a couple on my arms and they aren't a very big deal at all. At first I was a bit worried about them, because they look like they might be skin cancer, but after they were tested and found to be negative, I don't really mind them.

The doctor did offer to try and take them off, but, really, as skin conditions goes lichenoid keratoses could be worse.

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