Hyperkeratosis Lenticularis Perstans: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Hyperkeratosis Lenticularis Perstans?
A dermatologist usually treats this condition. Dermatologists specialize in diseases of the skin, hair, and nails, can tell apart conditions that look alike, and can perform biopsies in the office. Because this condition is rare, they are often the surest path to an accurate diagnosis.
What it is
Hyperkeratosis lenticularis perstans is a rare skin condition. The name describes what happens: hyperkeratosis means the outer layer of skin becomes too thick, lenticularis means the spots are lentil-shaped, and perstans means they last a long time. Doctors sometimes call it Flegel's disease. It is not an infection and cannot spread to other people, and it is not skin cancer.
Symptoms
The main sign is a group of small, flat-topped bumps, usually red, brown, or skin-colored, each often covered by a rough, scaly patch. When the scale comes off, it can leave a small pit or a tiny bleeding point. The bumps most often appear on the lower legs, the tops of the feet, and sometimes the arms or ears, and they rarely go away on their own.
Causes and who gets it
Doctors do not fully know what causes this condition. Some research suggests a problem with skin cells that normally help the skin shed its outer layer, and there may be a genetic link. It most often appears in adults between about 30 and 60.
How doctors diagnose it
There is no blood test. A doctor usually starts by looking at the skin and asking how long the spots have been there. Because the bumps can look like warts, age spots, or lichen planus, the most common next step is a skin biopsy: a small piece of skin is removed, usually after numbing, and a specialist examines it under a microscope to confirm the diagnosis.
Treatment
No single treatment works for everyone, and the spots often come back after treatment stops. Doctors usually try treatments that soften or thin the thickened skin, such as retinoid or steroid creams. Some doctors remove individual spots by freezing them with liquid nitrogen, called cryotherapy.
When to see a doctor
Anyone who notices rough, scaly bumps that do not go away should have them checked, especially if the spots are spreading, changing, bleeding, or causing discomfort. A skin exam can rule out conditions that look similar.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can be a good first stop, since these doctors often have longer visits. If the spots look like this rare condition, they will usually refer the patient to a dermatologist.
Common questions
Is hyperkeratosis lenticularis perstans dangerous?
No. It is a benign condition, which means it is not cancer and does not spread inside the body. Its main effects are on appearance and, for some people, mild itching or irritation.
Can it be cured?
There is no known cure. Treatments can reduce the thickness and redness of the spots for many people. However, the spots often return after treatment ends, and results vary from person to person.
Is it contagious?
No. It cannot be passed to family members, friends, or others through touch, shared towels, or any other contact.
Does it affect children?
It almost always appears in adults. Cases in children are very rare.
Sources
- NIH Genetic and Rare Diseases Information Center - Hyperkeratosis lenticularis perstans
- MedlinePlus - Skin Conditions
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
