A report describes a case of a 78-year-old man with skin type 2 who presented with a single asymptomatic, persistent, raised lesion on the right side of the chest for the past 2 months. He did not receive any treatment for the same.

Examination revealed a solitary well-defined violaceous, nontender plaque (3 × 4 cm dimension) over the infraclavicular area. No signs of erosion or ulceration or other physical deformities were noted.

Actinic keratosis, benign lichenoid keratosis (BLK), Bowen′s disease and lichen planus were considered the differential diagnosis.

Dermatoscopy revealed a reticulated pattern of bluish-grey papules and linear mild erythema in the background suggesting BLK. The absence of Wickham striae ruled out the dermatoscopic diagnosis of lichen planus.

Hyperkeratosis, hypergranulosis, acanthosis and a band-like lymphocytic infiltrate at the dermo-epidermal junction with multiple colloid bodies were seen in the histopathology.

Other investigations were within normal limits.

Topical 5% fluorouracil to be applied once a day for 2 weeks was prescribed. The patient responded to the treatment and showed a near-complete resolution.

Source: Mhatre A, Nadkarni N, Patil S, et al. A case of benign lichenoid keratosis. Indian J Dermatopathol Diagn Dermatol. 2015;2:49-51.