Lichen aureus (LA) presents an inflammatory infiltrate with a lichenoid pattern, which mainly localizes to the superficial dermis, and it is admixed with extravasated erythrocytes. We present the case of a 12-year-old male who had a 1.3-cm golden-brown-color patch on the right upper back for 2 weeks. Histopathologic examination revealed a lichenoid, superficial, and deep perivascular lymphocytic infiltrate with perineural and periappendageal involvement, extravasated erythrocytes, papillary dermal edema, and hemosiderophages. The perineural and periappendageal infiltrate is unusual for LA and suggestive of lichen striatus (LS). In addition, the presence of perineural inflammation is not a common feature for either LA or LS. However, given the clinical findings, taken together, these features were interpreted as being most consistent with LA. To the best of our knowledge, no previous case of LA has been reported with histological features of perineural inflammation and LS.