Background: Lichen ruber is a rare inflammatory mucocutaneous dermatosis with unknown etiology. Paraneoplastic manifestations of the disease are rare. Eruptions of lichen ruber subsequent to traumas such as surgery or radiotherapy are described as Köbner’s phenomenon. Patients and Methods: A 72-year-old woman presented at our institution because of increasing, extensive erosive epitheliolyses of the genital and gluteal area two years after surgery and radiotherapy because of vulvar cancer. Results: Thorough clinical as well as histological examination revealed a localized lichen ruber reaction. All epitheliolyses healed well within weeks under topic treatment with steroids. Conclusion: Lichen ruber is a rare dermatologic reaction that can occur several months after surgery and radiotherapy and has to be taken into account on examination of patients with late-onset skin reactions after local cancer treatment.

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