No. LPLK is benign and does not transform into skin cancer. The only reason to seek treatment is symptom relief, cosmetic preference, or diagnostic certainty when the appearance is not classic. LPLK is one of the more common benign mimics of basal cell carcinoma and Bowen disease, which is why doctor-led dermatoscopic assessment matters.

Why did my sun spot suddenly turn red or grey?

That is a classic LPLK story. LPLK often represents an inflamed regression of a prior harmless pigmented lesion — typically a solar lentigo or a seborrhoeic keratosis. The immune system starts to clear the original lesion, producing local inflammation that changes the appearance to red, red-brown, grey or multi-toned. The change is alarming but, once the diagnosis is confirmed, it is reassuring — the original lesion is actively fading.

Not always. If the dermatoscopic pattern is classic for LPLK and the history fits — a sun-exposed site, prior pigmented lesion that has changed — monitoring is reasonable. If the dermatoscopic features are not classic, or if there are any melanoma-like or BCC-like features, biopsy is the safest pathway to confirm the diagnosis and rule out malignancy. At The Skin Doctor, lesions of any dermatoscopic uncertainty are biopsied rather than ablated.

Will it go away on its own?

Often yes. Many LPLKs fade over weeks to months as the inflammation settles, leaving either clear skin or a faint mark. Watchful waiting with photographic follow-up is the commonest approach when the diagnosis is dermatoscopically clear. Removal is typically reserved for symptomatic, cosmetically bothersome, or diagnostically uncertain lesions.

What's the difference between LPLK and lichen planus?

The 'lichen planus-like' part of the name refers to how LPLK looks under the microscope — the inflammatory pattern resembles lichen planus. But LPLK and lichen planus are not the same condition. Lichen planus is a chronic inflammatory skin disease with multiple itchy purple-coloured lesions, often on the wrists, ankles and inside the mouth. LPLK is usually a single benign lesion on sun-exposed skin. The treatment pathways are completely different.

Can LPLK be confused with skin cancer?

Yes — and this is the most important practical point. Clinical studies show LPLK is frequently misdiagnosed as basal cell carcinoma (and sometimes Bowen disease) when assessed on appearance alone. Dermoscopy and, where uncertain, biopsy resolve the diagnostic question. If your main concern is ruling out skin cancer, the Skin cancer types page covers the pathway specifically.

If I want it removed, which method is best?

If diagnostic certainty matters, shave removal with histology is usually preferred. If the diagnosis has already been confirmed and the priority is cosmetic, curettage, cryotherapy, laser or radiofrequency ablation can be discussed based on lesion location, depth, your skin type, and any prior pigmentation problems. Cryotherapy carries some hypopigmentation risk in darker Fitzpatrick skin types, so laser or radiofrequency is often preferred for cosmetically sensitive locations in melanin-rich skin.

Do I need a referral?

No referral is required. You can book directly. A referral from your GP or treating clinician is welcome — it helps with collegial communication and continuity of care — but is not a barrier to accessing the service. Both clinics (Ivanhoe and Diamond Creek) operate the same pathway.

Inflammatory benign lesion

Lichenoid Planus-Like Keratosis(LPLK)

Name: LPLK Melbourne — Lichenoid Keratosis Assessment
Published: 2026-06-06

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 the skin. 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. It often forms when the skin "reacts" to a pre-existing harmless spot such as a solar lentigo or a seborrhoeic keratosis as it regresses.

By Dr Christopher Irwin, MBChB, FRACGP, MMed (Skin Cancer), FACAM, MSCCA

Last reviewed 2026-06-06 · Editorial policy

In brief

LPLK is benign and does not transform into skin cancer.
It often arises from an inflamed regressing solar lentigo or seborrhoeic keratosis.
LPLK is frequently misdiagnosed as basal cell carcinoma on clinical appearance alone — dermoscopy and biopsy resolve uncertainty.
Many LPLKs fade spontaneously over weeks to months — watchful waiting is reasonable when the diagnosis is clear.
Removal is appropriate when symptomatic, cosmetically bothersome or diagnostically uncertain.
The "sun spot that suddenly turned red or grey" is a classic LPLK story.
Shave removal with histology is preferred when diagnostic certainty matters; laser or radiofrequency is preferred for cosmetic priority after diagnosis is confirmed.
LPLK and lichen planus are biologically and clinically different — same microscopic pattern, different conditions and different treatment pathways.
Cryotherapy is used cautiously in darker Fitzpatrick skin types because of hypopigmentation risk.

Quick definition

Lichenoid planus-like keratosis (LPLK) — also called lichenoid keratosis or benign lichenoid keratosis — is a harmless inflamed skin lesion that often represents the regression of a prior benign pigmented lesion (typically a solar lentigo or seborrhoeic keratosis). Not skin cancer, but frequently misdiagnosed as basal cell carcinoma on appearance alone — the colour change from inflammation can look alarming. Doctor-led dermatoscopic assessment confirms the diagnosis; biopsy is the safer pathway when dermatoscopic features are not classic. Most LPLKs fade spontaneously over weeks to months — watchful waiting is the commonest approach. Removal is reserved for symptomatic, cosmetically bothersome, or diagnostically uncertain lesions.

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)

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), or
a seborrhoeic keratosis ^(1,2)

Common associations include:

sun exposure — many appear on sun-exposed areas ^(1,2)
minor irritation or 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 — sometimes multi-toned
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 or 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 or stingy
irritated when rubbed

Significant pain, persistent bleeding, or rapid ulceration is not typical for LPLK and should be assessed promptly.

Why LPLK 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 dermatoscopic 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 LPLK

Clinical history and examination. We consider:

how long the lesion has been present
whether it started as a “sun spot” that then changed
symptoms (itch, irritation)
any rapid change or bleeding

Dermoscopy. A handheld magnifier 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)

How we book LPLK appointments

We offer two booking pathways:

Doctor-led assessment (20 minutes) — dermatoscopic review with Dr Chris Irwin, diagnosis confirmed and management discussed. Most patients with a single lesion need only this appointment.
Combined assessment + dermal therapist (20 min + 40 min) — for patients with multiple lesions wanting a comprehensive cosmetic plan, or interested in laser therapy for removal. The combined model maps which lesions to address, which technique suits each, and how to minimise marks and downtime.

The booking flow in the sidebar takes you to whichever option you choose.

Treatment options (usually none)

Because LPLK is benign and often resolves spontaneously, no treatment is required unless:

it is symptomatic (itchy, irritated), or
cosmetically bothersome, or
diagnosis is uncertain and removal or 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 diagnostic certainty)

Options depend on lesion type and location and may include:

shave removal — often preferred when tissue is needed for histology
curettage / electrosurgery
cryotherapy in selected cases (caution in darker skin — hypopigmentation risk)
laser or radiofrequency ablation for selected lesions and 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 or crusting repeatedly
“doesn’t look like your other spots”
persistent and not settling over time

If you are unsure what a spot is in general, start at Other Dermatological Conditions.

Book an LPLK assessment

If you have noticed a new or changing spot and want a clear answer, the booking panel in the sidebar takes you to the assessment appointment with Dr Chris Irwin at Ivanhoe or Diamond Creek. Both clinics operate the same patient pathway:

Ivanhoe — Unit 1/1065 Heidelberg Road, Ivanhoe VIC 3079
Diamond Creek — Shop 12/67 Main Hurstbridge Road, Diamond Creek VIC 3089

Symptoms

Usually a single small spot — typically a few millimetres up to about 1 cm across.
Colour varies as the lesion inflames and resolves — pink, red, red-brown, grey or brown, sometimes multi-toned within one lesion.
May look flat or slightly raised, with a fine scale or slightly rough surface.
Common sites — chest and upper back, shoulders, forearms, upper arms and hands; less commonly neck or face.
Often asymptomatic — frequently noticed only because it looks different.
Sometimes mildly itchy, tingly or irritated when rubbed.
Classic "sun spot that suddenly turned red or grey" history — often arises from a regressing solar lentigo or seborrhoeic keratosis.
Significant pain, persistent bleeding or rapid ulceration is not typical and warrants prompt assessment.

Causes & contributors

Local immune reaction in the skin, often during regression of a pre-existing benign lesion.
Commonly arises in inflamed solar lentigines (sun spots).
Can arise from regressing seborrhoeic keratoses.
Sun-exposed skin is the typical site — a cumulative UV exposure association is recognised.
Minor irritation or friction in some cases.
Middle age and later adulthood is typical onset.

Diagnosis

LPLK is often diagnosable on clinical examination combined with dermoscopy — a handheld magnifier helps reveal patterns that support a benign regression process. Because LPLK is frequently misdiagnosed as basal cell carcinoma (and sometimes Bowen disease) on clinical appearance alone, biopsy is the definitive way to confirm the diagnosis and rule out malignancy when dermoscopic features are not classic or when atypical features are present. At The Skin Doctor, lesions of dermatoscopic uncertainty are biopsied rather than ablated — vaporising a misdiagnosed lesion is a serious diagnostic delay.

Treatment options

Watchful waiting (commonest approach)

LPLK is benign and often resolves spontaneously. Many lesions fade over weeks to months as the inflammation settles. Monitoring with photographic follow-up is often the right choice when the diagnosis is dermatoscopically clear.

Symptom relief

A short course of an anti-inflammatory topical may be used to reduce itch and redness if the lesion is symptomatic.

Shave removal (preferred when tissue is needed)

Often preferred when tissue is needed for histology — provides diagnostic certainty and removes the lesion in a single step. The right choice when there is dermatoscopic uncertainty.

Curettage / electrosurgery

Useful for selected lesions and locations where shave removal is not ideal.

Cryotherapy (selected cases)

Considered in selected cases for cosmetic reasons. Carries some risk of hypopigmentation on darker skin types.

Laser or radiofrequency ablation →

For selected lesions where cosmetic priority is high — best after confirmation of diagnosis. Not used when histology certainty is needed because there is no tissue specimen.

When to see a doctor

Book a review if the lesion is new and changing in adulthood, irregular in colour or border, repeatedly bleeding or crusting, doesn't look like your other spots, or is persistent and not settling over time. If a previous "sun spot" has suddenly turned red or grey, that is a common LPLK story but should still be assessed before any cosmetic ablation. A new pigmented or red lesion appearing after age 40, particularly on sun-exposed skin, always warrants dermatoscopic review — the "ugly duckling" sign and dermatoscopic features guide whether monitoring, biopsy or removal is the right pathway.

Frequently asked questions

Is LPLK dangerous?

No. LPLK is benign and does not transform into skin cancer. The only reason to seek treatment is symptom relief, cosmetic preference, or diagnostic certainty when the appearance is not classic. LPLK is one of the more common benign mimics of basal cell carcinoma and Bowen disease, which is why doctor-led dermatoscopic assessment matters.
Why did my sun spot suddenly turn red or grey?

That is a classic LPLK story. LPLK often represents an inflamed regression of a prior harmless pigmented lesion — typically a solar lentigo or a seborrhoeic keratosis. The immune system starts to clear the original lesion, producing local inflammation that changes the appearance to red, red-brown, grey or multi-toned. The change is alarming but, once the diagnosis is confirmed, it is reassuring — the original lesion is actively fading.
Do I need a biopsy?

Not always. If the dermatoscopic pattern is classic for LPLK and the history fits — a sun-exposed site, prior pigmented lesion that has changed — monitoring is reasonable. If the dermatoscopic features are not classic, or if there are any melanoma-like or BCC-like features, biopsy is the safest pathway to confirm the diagnosis and rule out malignancy. At The Skin Doctor, lesions of any dermatoscopic uncertainty are biopsied rather than ablated.
Will it go away on its own?

Often yes. Many LPLKs fade over weeks to months as the inflammation settles, leaving either clear skin or a faint mark. Watchful waiting with photographic follow-up is the commonest approach when the diagnosis is dermatoscopically clear. Removal is typically reserved for symptomatic, cosmetically bothersome, or diagnostically uncertain lesions.
What's the difference between LPLK and lichen planus?

The 'lichen planus-like' part of the name refers to how LPLK looks under the microscope — the inflammatory pattern resembles lichen planus. But LPLK and lichen planus are not the same condition. Lichen planus is a chronic inflammatory skin disease with multiple itchy purple-coloured lesions, often on the wrists, ankles and inside the mouth. LPLK is usually a single benign lesion on sun-exposed skin. The treatment pathways are completely different.
Can LPLK be confused with skin cancer?

Yes — and this is the most important practical point. Clinical studies show LPLK is frequently misdiagnosed as basal cell carcinoma (and sometimes Bowen disease) when assessed on appearance alone. Dermoscopy and, where uncertain, biopsy resolve the diagnostic question. If your main concern is ruling out skin cancer, the Skin cancer types page covers the pathway specifically.
If I want it removed, which method is best?

If diagnostic certainty matters, shave removal with histology is usually preferred. If the diagnosis has already been confirmed and the priority is cosmetic, curettage, cryotherapy, laser or radiofrequency ablation can be discussed based on lesion location, depth, your skin type, and any prior pigmentation problems. Cryotherapy carries some hypopigmentation risk in darker Fitzpatrick skin types, so laser or radiofrequency is often preferred for cosmetically sensitive locations in melanin-rich skin.
Do I need a referral?

No referral is required. You can book directly. A referral from your GP or treating clinician is welcome — it helps with collegial communication and continuity of care — but is not a barrier to accessing the service. Both clinics (Ivanhoe and Diamond Creek) operate the same pathway.

References

Related conditions

Related treatments

Moles, Skin Lumps & Bumps Removal

Medically reviewed by Dr Christopher Irwin, MBChB, FRACGP, MMed (Skin Cancer), FACAM, MSCCA · Last reviewed 2026-06-06 · Editorial policy