We appreciate the interest that our article, "Keratosis Lichenoides Chronica,"1 has stimulated in Dr. Cohen. We wish to compliment Dr. Cohen for recognizing the similarity of his case and ours. However, there are several discrepancies in the clinical and morphologic appearance of the patients that bear repeating.
The most striking difference is in the structure of the individual lesions. Dr. Cohen's patient exhibits marked verrucous, psoriasiform scales, whereas our patient has mainly erythematous papules with much thinner yellow-grey scales. In Dr. Cohen's patient, the eruption is in areas exposed to sunlight (as would be expected in discoid lupus erythematosus). In our patient, lesions were present in some nonsun-exposed areas, ie, groin and penis. Our patient has repeatedly denied any relationship of his eruption to exposure to sunlight.
Other discrepancies in the clinical picture include lack of any laryngeal abnormalities in Dr. Cohen's patient, failure of the rash in his