Solitary Lichen Planus Keratosis: A Potential Clinical and Dermoscopic Mimic of Malignant Skin Neoplasm.

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.