Mansour Billah Lamia, Chiheb Soumiya, Oukabli Mohammed, Eljazouly Madiha
Dermatology and Venerology, Sheikh Khalifa University Hospital, Casablanca, MAR.
Dermatology, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR.
Cureus. 2025 May 7;17(5):e83630. doi: 10.7759/cureus.83630. eCollection 2025 May.
Solitary lichen planus keratosis (SLPK) is a benign cutaneous lesion, often misdiagnosed due to its clinical and dermoscopic similarities to malignant conditions like basal cell carcinoma (BCC) and melanoma. We present two case reports: an 82-year-old male with an erythematous, scaly lesion on his back, and a 66-year-old female with an itchy lesion on her thigh while undergoing chemotherapy for multiple myeloma. Dermoscopic findings included orange-erythematous backgrounds with scales, sharp borders, telangiectasias, and shiny white blotches in both patients. Histopathological analysis confirmed the diagnosis of SLPK in both cases. Although lesions often regress spontaneously, treatment options such as cryotherapy and curettage are available for symptomatic cases. Dermoscopy lacks pathognomonic features, but clues such as orange areas and scales in non-photo-exposed areas may aid in diagnosis. However, due to its potential to mimic malignant lesions, histopathological confirmation remains essential for accurate diagnosis. Clinicians should be aware of SLPK's clinical subtypes and dermoscopic features to avoid unnecessary excisions, as it is a benign condition with no carcinomatous potential.
孤立性扁平苔藓角化病（SLPK）是一种良性皮肤病变，由于其临床和皮肤镜表现与基底细胞癌（BCC）和黑色素瘤等恶性疾病相似，常被误诊。我们报告两例病例：一名82岁男性背部有红斑鳞屑性病变，一名66岁女性在接受多发性骨髓瘤化疗时大腿出现瘙痒性病变。两名患者的皮肤镜表现均包括橙红色背景伴鳞屑、边界清晰、毛细血管扩张和亮白色斑片。组织病理学分析确诊两例均为SLPK。尽管病变通常会自发消退，但对于有症状的病例，可采用冷冻疗法和刮除术等治疗方法。皮肤镜缺乏特异性特征，但非曝光部位的橙色区域和鳞屑等线索可能有助于诊断。然而，由于其有模仿恶性病变的可能，组织病理学确诊对于准确诊断仍然至关重要。临床医生应了解SLPK的临床亚型和皮肤镜特征，以避免不必要的切除，因为它是一种无癌变潜能的良性疾病。
