History: 5751kh Man in his late 60s with a three month history of these itchy keratotic papules on both lower legs. Biopsies have been taken from two of these lesions around the knee. He has had a strong topical steroid on them for 3 weeks. Exclude SCCs.They look like prurigo papules.

Description: Excoriated keratotic papules legs

Comments: There is marked epidermal hyperplasia with lichenoid change at the tips of the rete ridges accompanied by upper dermal inflammation. These features most suggest hypertrophic lichen planus.