What Is Lichen Aureus?

Mary McMahon
Mary McMahon

Lichen aureus is a rare skin condition where patches of discoloration appear, usually on the lower limbs. These patches can be yellowish to rust-colored and may be very resistant to treatment in some patients. A dermatologist can evaluate a patient with skin abnormalities to determine their cause and provide treatment recommendations. The best treatment option can depend on the patient's history and the precise nature of the skin problem.

Lichen aureus may develop above a varicose vein.
Lichen aureus may develop above a varicose vein.

The causes of lichen aureus are not well understood. The growths sometimes develop above a varicose vein or in the wake of trauma, but not necessarily. They may appear in isolation or can multiply in some patients, and tend to concentrate on the lower limbs. The condition is not fatal or dangerous, but can cause social discomfort for patients if the marks are in a prominent location.

A biopsy may be conducted if a doctor suspects that a patient has lichen aureus.
A biopsy may be conducted if a doctor suspects that a patient has lichen aureus.

If a doctor suspects a patient has this condition, a biopsy may be recommended. The biopsy can check for abnormal cells and cellular changes of concern. It can also help the doctor eliminate alternative diagnoses that might require different treatment approaches. This can usually be done in an office with a quick scraping of the abnormality.

One treatment option is topical steroid medications. The patient may need to take very potent drugs, applied in a cream or ointment to cover the growth. These medications need to be used with care, because they can have serious side effects, including skin thinning. Patients who do not respond to topical steroids may need a different medication, or the doctor could consider abandoning steroid therapy altogether.

Another lichen aureus treatment is psoralens and ultraviolet A (UVA) therapy, known as PUVA. In this therapy, the patient takes medications before a brief session of UVA radiation. Some patients respond very well to PUVA and may experience significant clearing of the lichen aureus rash. Several sessions should determine if the therapy is appropriate for a patient.

Even with treatment, the lichen aureus can return. Patients may develop a chronic skin problem that does not resolve, requiring multiple rounds of treatment to suppress the growth whenever it recurs. In any situation where skin changes become chronic, a doctor may recommend monitoring for cancer, as repeated inflammation and irritation can expose the patient to the risk of skin cancers. The constant sloughing of old skin and development of new skin can increase the chance that a rogue cell will develop and multiply without intervention from the immune system.

Topical cream and ointments may be used to treat lichen aureus.
Topical cream and ointments may be used to treat lichen aureus.
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a wiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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Discussion Comments


I want to know about the latest treatment and prognosis for lichen aureus.


I have had Lichen Aureaus for eight years now, but only just had a full diagnosis. It is not the nicest thing to see on your body and the steroid creams have not helped over the years. A doctor in New Zealand seems to feel that it can be reduced by reducing the amount of preservatives and food colourings you eat. No proof of this, but thinking about it, there is nothing to lose in trying as fresh food is far healthier. It's difficult to cut out processed foods in this day and age, but worth a try.

I find using E45 cream has reduced the red flare so I will continue with this. The way I look at it is it's not life threatening and just makes you a little bit more special.


@simrin-- Mine used to look like cayenne pepper, so they had a dark red color. And yes, they did fade a little over time and look like a darker brown now. However, new spots are always dark red.

My dermatologist said that lichen aureus is caused by broken capillaries (tiny blood vessels). But they're not always sure what causes the capillaries to break. It could easily happen from some kind of trauma or injury. But doctors are not sure why it happens in other cases.

I have seen lichen aureus pictures and you're right, very rarely, people get them on the face. One girl had it on her lips! I am glad that they are on my legs and not on a more visible area.

@alisha-- What color is your purpuric dermatitis?

I'm sorry, I haven't gotten the PUVA therapy, so I can't help you about that. But I have used steroid cream and I agree with you that it helps. My dermatitis used to be red, but they've faded over time. It might be because of the steroid cream, I'm not sure. They're now a brownish color and they are not spreading. I'm also using vitamin K cream which my dermatologist said would help.

What confuses me the most about this condition is the cause. Mine also developed very suddenly and I didn't suffer from any injury or illness prior to it. I have absolutely no idea what could have caused it. It's frustrating to deal with a condition with an unknown cause and no cure. I just hope that the spots don't spread. I'm already very conscious of them and dress to hide. They're on my feet and legs.

I guess we're still lucky though. I've heard that it's even possible to get them on the face.


I have lichen aureaus. They started showing up on my legs out of nowhere four months ago. At first, I thought it was a bruise but later noticed that it was little red spots that were spreading. I went to the dermatologist right away who did a biopsy and confirmed that it's a pigmented purpura called lichen aureus.

He prescribed steroid cream and it helped a lot. The spots that were there didn't go away, but at least new ones didn't show up while I was using the cream. When I stopped using it however, new spots started appearing again.

I don't know what to do. My doctor now wants me to get the PUVA therapy and I guess I will. I wish I could continue to use the steroid cream but I can't. I hope the PUVA therapy works.

Has anyone gotten PUVA therapy? Did it clear up your lichen aureus or just prevent new ones from forming?

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