By Gary M. White, MD

Lichen spinulosus Courtesy O. Dale Collins, MD

Lichen spinulosus (LS) is a rare idiopathic cutaneous eruption characterized by follicular keratotic spiny papules that are grouped in large patches.


Grouped, follicular, hyperkeratotic, 1-2 mm spines in a child, on the trunk or extremities is characteristic. The differential diagnosis includes psoriasis which in the child may present as grouped follicular spines.


No treatment is needed. Salicylic acid gel 6% with or without occlusion has worked well. Other treatment possibilities include topical adapalene, salicylic acid, 12% ammonium lactate lotion, tacalcitol, and tretinoin.


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