We feel that it is possible to make a reasonably consistent clinical diagnosis of lichen planus—like keratosis on the basis of several criteria. These criteria include physical appearance, location and short duration of the lesion, clinical symptoms such as pruritus and pain, age and sex of the patient, and the frequent presence of a preceding lentigo. Clinical data on fifty-nine histologically confirmed cases are presented. Some interesting features of this curious condition are discussed. Because of the clinical similarity of lichen planus-like keratosis to other sometimes more ominous lesions, microscopic confirmation of the diagnosis is still recommended.