Keratosis lichenoides chronica: Case-based review of treatment options

Keratosis lichenoides chronica (KLC) is a rare dermatological condition characterized bykeratotic papules arranged in a parallel linear or reticular pattern and facial lesions resemblingseborrheic dermatitis or rosacea. The clinical, histological and therapeutic information on 71patients with KLC retrieved through a PubMed search plus one our new case were analyzed.KLC affects patients of all ages, with a modest male predominance. Pediatric cases representabout one quarter of patients. Diagnosis is usually delayed and histologically confirmed. Allpatients have thick, rough and scaly papules and plaques arranged in a linear or reticularpattern, on limbs (480%) and trunk (about 60%). Face involvement is described in two-thirds ofpatients. Lesions are usually asymptomatic or mildly pruritic. Other manifestations, such aspalmoplantar keratoderma, mucosal involvement, ocular manifestations, nail dystrophy, arereported in 20–30% of patients. Children present more frequently alopecia. No controlled trialsare available. Results from small case series or single case reports show that the best treatmentoptions are phototherapy and systemic retinoids, alone or in combination, with nearly half ofpatients reaching complete remission. Systemic corticosteroids as well as antibiotics andantimalarials are not effective.