Lichen aureus is a skin condition causing yellowish to rust-colored patches on the lower extremities. Treatment options include topical steroids and PUVA therapy, but the condition can be resistant to treatment and may recur. Biopsy may be necessary to rule out other diagnoses and monitor for cancer.
Lichen aureus is a rare skin condition in which patches of discoloration appear, usually on the lower extremities. These patches can be yellowish to rust-colored and can be very resistant to treatment in some patients. A dermatologist can evaluate a patient with skin abnormalities to determine the cause and provide treatment recommendations. The best treatment option may depend on the patient’s history and the precise nature of the skin problem.
The causes of lichen aureus are not well understood. The growths sometimes develop over a varicose vein or in the wake of trauma, but not necessarily. They can appear isolated or can multiply in some patients and tend to concentrate on the lower extremities. The condition is not fatal or dangerous, but can cause social discomfort for patients if the signs are prominent.
If a doctor suspects a patient has this condition, a biopsy may be recommended. The biopsy can check for abnormal cells and worrisome cellular changes. It can also help your doctor rule out alternative diagnoses that may require different treatment approaches. This can usually be done in an office setting with a quick scrape of the anomaly.
One treatment option is topical steroid medications. The patient may need to take very strong medications, applied in cream or ointment to cover the growth. These drugs should be used with caution because they can have serious side effects, including thinning of the skin. Patients who don’t respond to topical steroids may need a different medication, or the doctor may consider giving up steroid therapy altogether.
Another treatment for lichen aureus is psoralen and ultraviolet A (UVA) therapy, known as PUVA. In this therapy, the patient takes medication before a short session of UVA radiation. Some patients respond very well to PUVA and may experience significant disappearance of the lichen aureus rash. Several sessions should determine whether therapy is appropriate for a patient.
Even with treatment, lichen aureus can come back. Patients may develop a chronic skin problem that doesn’t clear up, requiring multiple courses of treatment to suppress growth each time it recurs. In any situation where skin changes become chronic, a doctor may recommend monitoring for cancer, as repeated inflammation and irritation can put the patient at risk for skin cancers. The constant shedding of old skin and the development of new can increase the chance of a rogue cell developing and multiplying without intervention from the immune system.
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