Melissa Kaori S. Litao, MD

The rash has been present for 2 years. Originally on the trunk and extremities it has now spread to her face and hands. She has been diagnosed as having and been unsuccessfully treated for nummular eczema and tinea corporis. What's your Dx?

Lichen spinulosus is a rare, hyperkeratotic dermatosis similar to keratosis pilaris. It is most common in children, adolescents, young adults with male predominance. Treatment includes keratolytics and emollients.