The condition can persist for decades. LS in most patients remits spontaneously in a year or two. The keratotic papules group into large plaques can spread rapidly to affect large areas of skin. Patches and plaques of follicular papules have a diameter that ranges from 2-5 cm. The patches are distributed symmetrically over the integument.
Patches affect the neck, buttocks, abdomen, trochanters, knees, and extensor surfaces of the arms.
Individual papules are flat to conical. The individual papules are usually small, about 1-3 mm in diameter. Papules have a pointed or hairlike horny spine that extends about 1 mm about the tip of the follicle. Infection has been postulated but there are no data to support this hypothesis. A report notes a family with the condition in 4 generations, an observation that suggests a genetic predisposition.