Konstantinos Liopyris1,2, Cristian Navarrete-Dechent1,3, Stephen W Dusza1, Ashfaq A Marghoob1, Liang Deng1, Barbara B Wilson4, Michael A Marchetti1. 1. Dermatology Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA. 2. Department of Dermatology, A. Syggros Hospital, University of Athens, Athens, Greece. 3. Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. 4. Department of Dermatology, University of Virginia, Charlottesville, Virginia, USA.
Abstract
BACKGROUND/ OBJECTIVES: Lichen planus-like keratoses (LPLK) are benign skin lesions that can mimic malignancy; the clinical and dermoscopic features distinguishing lichen planus-like keratoses from skin tumors have not been extensively studied. The objective of this study was to identify dermoscopic features that may prevent unnecessary biopsies of lichen planus-like keratoses. METHODS: Retrospective, single-center, observational study of biopsied skin lesions at a tertiary center. We compared 355 lichen planus-like keratoses to 118 non-lichen planus-like keratoses lesions with lichen planus-like keratosis in the differential diagnosis biopsied from August 1, 2015, to December 31, 2016. The investigators were blinded to the diagnosis of the lesions. RESULTS: Lichen planus-like keratoses were most frequently non-pigmented (61.7%), truncal (52.1%), and on sun-damaged skin (69.6%); the majority occurred in Whites (95.5%) and females (62.8%). Dermoscopically, lichen planus-like keratoses were more likely than non-lichen planus-like keratoses to have scale (42.5% vs 31.4%, P = 0.03) and orange colour (8.2% vs 0.9%, P = 0.01). Among lesions with peppering (n = 76; 63 lichen planus-like keratoses and 13 non-lichen planus-like keratoses), coarse ± fine peppering (73% vs 38.5%, P = 0.02) and peppering as the only feature (34.9% vs 0%, P = 0.01) were associated with lichen planus-like keratoses. CONCLUSIONS: Lichen planus-like keratoses can be challenging to distinguish from benign and malignant skin tumors. The presence of dermoscopic scale and orange colour may aid in the recognition of lichen planus-like keratosis. Coarse peppering and the presence of peppering as the only dermoscopic feature may further aid the identification of pigmented lichen planus-like keratoses.
BACKGROUND/ OBJECTIVES: Lichen planus-like keratoses (LPLK) are benign skin lesions that can mimic malignancy; the clinical and dermoscopic features distinguishing lichen planus-like keratoses from skin tumors have not been extensively studied. The objective of this study was to identify dermoscopic features that may prevent unnecessary biopsies of lichen planus-like keratoses. METHODS: Retrospective, single-center, observational study of biopsied skin lesions at a tertiary center. We compared 355 lichen planus-like keratoses to 118 non-lichen planus-like keratoses lesions with lichen planus-like keratosis in the differential diagnosis biopsied from August 1, 2015, to December 31, 2016. The investigators were blinded to the diagnosis of the lesions. RESULTS: Lichen planus-like keratoses were most frequently non-pigmented (61.7%), truncal (52.1%), and on sun-damaged skin (69.6%); the majority occurred in Whites (95.5%) and females (62.8%). Dermoscopically, lichen planus-like keratoses were more likely than non-lichen planus-like keratoses to have scale (42.5% vs 31.4%, P = 0.03) and orange colour (8.2% vs 0.9%, P = 0.01). Among lesions with peppering (n = 76; 63 lichen planus-like keratoses and 13 non-lichen planus-like keratoses), coarse ± fine peppering (73% vs 38.5%, P = 0.02) and peppering as the only feature (34.9% vs 0%, P = 0.01) were associated with lichen planus-like keratoses. CONCLUSIONS: Lichen planus-like keratoses can be challenging to distinguish from benign and malignant skin tumors. The presence of dermoscopic scale and orange colour may aid in the recognition of lichen planus-like keratosis. Coarse peppering and the presence of peppering as the only dermoscopic feature may further aid the identification of pigmented lichen planus-like keratoses.
Authors: C Hafner; R Stoehr; J M M van Oers; E C Zwarthoff; F Hofstaedter; M Landthaler; A Hartmann; T Vogt Journal: Br J Dermatol Date: 2008-12-12 Impact factor: 9.302
Authors: Cristian Navarrete-Dechent; Konstantinos Liopyris; Ayelet Rishpon; Nadeem G Marghoob; Miguel Cordova; Stephen W Dusza; Aditi Sahu; Kivanc Kose; Margaret Oliviero; Harold Rabinovitz; Klaus J Busam; Michael A Marchetti; Chih-Chan J Chen; Ashfaq A Marghoob Journal: JAMA Dermatol Date: 2020-08-01 Impact factor: 10.282
Authors: Cristian Navarrete-Dechent; Miguel Cordova; Konstantinos Liopyris; Saud Aleissa; Milind Rajadhyaksha; Gil'ad Cohen; Ashfaq A Marghoob; Anthony M Rossi; Christopher A Barker Journal: J Am Acad Dermatol Date: 2020-08-20 Impact factor: 15.487