Department of Dermatology, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia.
School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Perth, WA, Australia.
Clin Exp Dermatol. 2017 Aug;42(6):663-666. doi: 10.1111/ced.13178. Epub 2017 Jun 21.
Lichenoid keratosis (LK), also known as benign lichenoid keratosis or lichen planus-like keratosis, is a solitary, pink to red-brown scaly plaque representing a host immunological response to a variety of precursor lesions. LK is often misdiagnosed as a dermatological malignancy owing to its clinical resemblance to basal cell carcinoma (BCC) or Bowen disease. We performed a retrospective analysis of the pathology records of a series of LK lesions with reference to the demographic features and accuracy of clinical diagnosis. The pathology records from 2008 to 2009 of 263 consecutive patients with a histological diagnosis of LK from a specialized skin laboratory were retrieved. Data relating to clinical diagnosis, age, sex, anatomical location, time of year of presentation and any coexistent pathological lesions adjacent to the LK were recorded. Mean age at presentation was 64 years (range 34-96), and 58% of patients were female. The most common anatomical site was the chest/anterior torso, followed by the back and legs. The most common coexisting lesion was solar keratosis at 14%, followed by seborrhoeic keratosis (SK) at 7.8%. The correct clinical diagnosis of LK was made in 29.5% of cases. The most common clinical diagnosis was BCC (47%), while SK was the preferred diagnosis in 18%. A clinical diagnosis was not given in 5.5% of cases. In conclusion, it appears that LK is frequently misdiagnosed, with misdiagnosis occurring in > 70% of cases in this study.
类扁平苔藓样角化病（LK），又称良性类扁平苔藓样角化病或扁平苔藓样角化病，是一种孤立的、粉红色至红棕色鳞屑性斑块，代表宿主对各种前驱病变的免疫反应。由于其临床类似于基底细胞癌（BCC）或 Bowen 病，LK 常被误诊为皮肤病恶性肿瘤。我们对一系列 LK 病变的病理记录进行了回顾性分析，并参考了临床诊断的准确性。我们从一个专门的皮肤实验室检索了 2008 年至 2009 年 263 例连续组织学诊断为 LK 的患者的病理记录。记录了与临床诊断、年龄、性别、解剖部位、就诊时间以及与 LK 相邻的任何共存病理病变相关的数据。就诊时的平均年龄为 64 岁（范围 34-96 岁），58%的患者为女性。最常见的解剖部位是胸部/前躯，其次是背部和腿部。最常见的共存病变是 14%的光化性角化病，其次是脂溢性角化病（SK），占 7.8%。在 29.5%的病例中做出了正确的临床诊断。最常见的临床诊断是 BCC（47%），而 SK 是 18%的首选诊断。5.5%的病例未做出临床诊断。总之，LK 似乎经常被误诊，在本研究中，超过 70%的病例存在误诊。
