CLINICAL CASES   

Giornale Italiano di Dermatologia e Venereologia 2003 June;138(3):251-6

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English, Italian

Keratosis lichenoides chronica. Case report and literature review

Menaguale G., Fazio R., Passarelli F., Fazio M.

Istituto Dermopatico dell’Immacolata IRCCS of Rome, Rome, Italy

Keratosis lichenoides chronica (KLC) is a rare chronic progressive dermatosis of unknown aetiology characterized by lichenoid hyperkeratotic papules typically arranged in a linear or reticulate pattern on the extremities or on the trunk, warty erythematosquamous plaques and seborrhea-like dermatitis on the face. The disorder frequently involves the oral or genital mucous membranes, the ocular area, the palmo-plantar zones and nails.Treatment is very difficult and often disappointing. Whether this disease is a variant of lichen planus is still questionable. Keratosis lichenoides chronica is very similar to lichen planus both clinically and histologically; some authors consider it to be a variant of the same process. Nevertheless, we agree with most of the authors that the disease is a distinct entity because several clinical features of KLC, such as facial dermatitis, eye involvement, resistance to systemic steroids, rarity of pruritus, absence of typical nail pterygium and oral involvement must be considered distinguishing features. We report a case of a 50-year-old woman who presented with keratotic plaques on the dorsa of the feet with a linear distribution and lichenoid papules grouped in a reticulate pattern on her thighs. A diagnosis of keratosis lichenoides chronica was clinically and histologically evident. Treatment with calcipotriol ointment and glycol-propilene 60% induced marked clinical improvement.