Abstract
Lichen Planus Follicularis Tumidus (LPFT) is a very rare variant of lichen planus with follicular involvement, clinically presenting as one or more violaceous to brownish plaques with comedones and milia-like cysts filled with keratin, presenting in the scalp and head and neck - predominantly in the retroauricular area. Histopathologically, LPFT is characterized by cystically dilated follicular structures with orthokeratotic content, surrounded by a dense lichenoid inflammatory infiltrate with interface reaction, reminiscent that of lichen planopilaris. We report a 44 year old male who presented a retroauricular plaque suspected to be seborrheic keratosis and that on histological examination, in conjunction with the clinical picture, was consistent with LPFT. Due to its rarity among the lichen planus spectrum, awareness of this clinical–pathological variant is crucial for its correct diagnosis and management.