Lichenoid Planus-Like Keratosis (LPLK) in Melbourne (Ivanhoe + Diamond Creek)
A harmless, inflamed “spot” that often looks dramatic while it’s settling down — and is very commonly mistaken for something more serious.
Lichenoid planus-like keratosis (LPLK) is a benign (non-cancerous) skin lesion. Despite the long name, it is usually a single small spot that represents an inflammatory reaction in the top layers of skin. (1,2)
The key message: LPLK is harmless and does not turn into skin cancer — but it can look like skin cancer, so new or changing lesions should be assessed properly. (1–3)
[Book a 20 minute appointment]
Doctor-led assessment with Dr Chris Irwin, including dermatoscopic review where appropriate.
Optional: if you’d like a comprehensive cosmetic plan (especially if you have multiple lesions), or you’re interested in laser therapy for removal/appearance, consider booking a combined 20 minute medical appointment followed by a 40 minute dermal therapist appointment.
Key takeaways
- LPLK is benign and often settles on its own over time. (1,2)
- It commonly forms when the skin “reacts” to a pre-existing harmless spot such as a solar lentigo (sun spot) or a seborrhoeic keratosis as it regresses. (1,2)
- It is frequently misdiagnosed clinically as basal cell carcinoma or other lesions because it can look red, brown, grey, or irregular while inflamed. (2,3)
- If there is any uncertainty, a biopsy provides definitive reassurance. (1–3)
Jump links
- What is LPLK?
- Why does it happen?
- What does it look like (and where does it appear)?
- Symptoms
- Why it can mimic skin cancer
- How we diagnose it (dermoscopy and biopsy)
- Treatment options (usually none)
- When to book
- FAQs
- Book
What is LPLK?
LPLK (also called lichenoid keratosis or benign lichenoid keratosis) is usually a small inflamed patch or thin plaque on the skin, most often appearing as a single lesion. (1,2)
The “lichen planus-like” part refers to how it can look under the microscope — it resembles the inflammatory pattern seen in lichen planus — but it is not the same condition as lichen planus. (1)
Why does it happen?
Doctors consider LPLK to be a local immune reaction in the skin. It often arises when the body starts to “clear” or inflame a pre-existing, harmless spot — commonly:
- a solar lentigo (sun spot) (see Solar lentigo), or
- a seborrhoeic keratosis (see Seborrhoeic keratosis). (1,2)
Common associations include:
- sun exposure (many appear on sun-exposed areas) (1,2)
- minor irritation/friction in some cases
- middle age and later adulthood (1,2)
What does it look like (and where does it appear)?
LPLK can be visually variable — which is why it causes anxiety.
Typical features:
- usually small (often a few mm up to ~1 cm) (1,2)
- can be pink/red, red-brown, grey, or brown
- may look flat or slightly raised
- may have fine scale or a slightly rough surface (1,2)
Common locations:
- chest and upper back
- shoulders and forearms
- upper arms and hands
- less commonly neck/face (1,2)
Most people have only one lesion. (1,2)
Symptoms
Many LPLKs cause no symptoms and are noticed only because they look different. (1,2)
Some may be mildly:
- itchy
- tingly/stingy
- irritated when rubbed
Significant pain, persistent bleeding, or rapid ulceration is not typical for LPLK and should be assessed promptly.
Why it can mimic skin cancer
While LPLK is harmless, it can look similar to more serious lesions because it:
- changes colour as it inflames and regresses
- can appear irregular or multi-toned (pink + brown/grey)
- may be scaly or crusty if irritated (1–3)
Clinical studies show LPLK is frequently misdiagnosed as basal cell carcinoma (and sometimes Bowen disease) based on appearance alone. (3)
This is why careful assessment (and biopsy when needed) is standard and appropriate.
If your main concern is ruling out skin cancer, see Skin cancer types and information.
How we diagnose it (dermoscopy and biopsy)
Clinical history and examination
We consider:
- how long it’s been present
- whether it started as a “sun spot” then changed
- symptoms (itch, irritation)
- any rapid change or bleeding
Dermoscopy
A dermoscope is a handheld magnifier that lets us see patterns beneath the surface. LPLK often has clues that support a benign regression pattern — but dermoscopy is also how we decide whether anything looks atypical and needs biopsy. (1,2)
Biopsy (when we need certainty)
If the appearance is not classic — or if there are melanoma-like or BCC-like features — we recommend a biopsy. This is the definitive way to confirm the diagnosis and rule out malignancy. (1–3)
Treatment options (usually none)
Because LPLK is benign and often resolves spontaneously, no treatment is required unless:
- it’s symptomatic (itchy/irritated), or
- cosmetically bothersome, or
- diagnosis is uncertain and removal/biopsy is appropriate. (1,2)
1) Watchful waiting (commonest approach)
Many lesions fade over months as the inflammation settles. (1,2)
2) Symptom relief (if itchy or inflamed)
A short course of an anti-inflammatory topical may be used to reduce itch and redness. (1,2)
3) Removal (if you want it gone, or for certainty)
Options depend on lesion type and location and may include:
- shave removal (often preferred when tissue is needed)
- curettage/electrosurgery
- cryotherapy in selected cases
- laser or radiofrequency ablation for selected lesions/cosmetic priorities (1,2)
For a broader overview of laser approaches, see Laser & Light Treatments hub.
When to book
Book a review if the lesion is:
- new and changing in adulthood
- irregular in colour or border
- bleeding/crusting repeatedly
- “doesn’t look like your other spots”
- persistent and not settling over time
If you’re unsure what a spot is in general, start at Other Dermatological Conditions.
FAQs
Is LPLK dangerous?
No. LPLK is benign and does not transform into skin cancer. (1,2)
Why did my sun spot suddenly turn red or grey?
That is a common story — LPLK often represents an inflamed regression of a prior harmless pigmented lesion. (1,2)
Do I need a biopsy?
Not always. If the dermoscopic pattern is classic, we may monitor. If there is any uncertainty, biopsy is the safest way to confirm the diagnosis. (1–3)
Will it go away?
Often yes — many LPLKs fade as the inflammation settles. (1,2)
Book
If you’ve noticed a “new” or changing spot and want a clear answer:
[Book a 20 minute appointment]
Optional: if you’d like a comprehensive cosmetic plan (especially for multiple lesions), or you’re interested in laser therapy, consider booking a combined 20 minute medical appointment followed by a 40 minute dermal therapist appointment.
Ivanhoe: Unit 1, 1065 Heidelberg Road, Ivanhoe VIC 3079
Diamond Creek: Shop 12, 67 Main Hurstbridge Road, Diamond Creek VIC 3089
References
1.DermNet NZ. Lichenoid keratosis (lichen planus-like keratosis). https://dermnetnz.org/topics/lichenoid-keratosis
2.Healthline. Lichenoid keratosis: treatment, dermoscopy, and pictures. https://www.healthline.com/health/lichenoid-keratosis
3.Maor D, Ondhia C, Yu LL, Chan JJ. Lichenoid keratosis is frequently misdiagnosed as basal cell carcinoma. Clin Exp Dermatol. 2017. https://pubmed.ncbi.nlm.nih.gov/28636260/