March 2018
- 60 year old female presented with a white, atrophic plaque on her vulva.
- Lichen sclerosus
- Morphea
Sections show a band of homogenized, sclerotic collagen underlying an atrophic epidermis.
A lymphocytic infiltrate is present below the band of homogenized collagen.
Lichen sclerosus
- Lichen sclerosus is a chronic inflammatory dermatosis with a predilection for the anogenital region
- Approximately 20% of patient have extragenital involvement
- The disease primarily affects middle-aged and elderly woman who are perimenopausal
- Cases in prepubertal children rarely occur
- LS presents as white to ivory plaques with follicular plugging and atrophy leading to a wrinkled scar-like appearance
- Patients may present with pruritus, pain, dysuria or dyspareunia
- Established lesions of LS are characterized by a homogenized band of collagen below a thinned epidermis with follicular plugging and an associated lymphocytic infiltrate with areas of vacuolar alteration
- Scattered necrotic keratinocytes are often present
- Early lesions can have a brisk, band-like infiltrate mimicking lichen planus
- Vulvar lesions may show acanthosis and changes corresponding to secondary lichenification
- Lichen sclerosus is associated with an increased risk of squamous cell carcinoma, and malignant transformation does occur in approximately 5% of patients with vulvar lichen sclerosus
- Lichen sclerosus is a chronic inflammatory dermatosis that often presents with pruritus and has a predilection for the anogenital region
- The disease primarily affects middle-aged and elderly woman who are perimenopausal
- LS presents as white to ivory plaques with follicular plugging and atrophy leading to a wrinkled scar-like appearance
- Established lesions of LS are characterized by a homogenized band of collagen below a thinned epidermis with follicular plugging and an associated lymphocytic infiltrate with areas of vacuolar alteration
- Lichen sclerosus is associated with an increased risk of squamous cell carcinoma, and malignant transformation does occur in approximately 5% of patients with vulvar lichen sclerosus