Dermoscopy of Extragenital Lichen Sclerosus

Abstract

L ICHEN SCLEROSUS (LS) IS A CHRONIC INFLAMmatory dermatosis that is characterized by the presence of white papules and atrophic plaques. We describe 4 women with asymptomatic whitish papules and atrophic plaques at various locations on the body. Histopathologic examination of the lesions showed atrophy of the epidermis, follicular plugging, and a lymphocytic infiltrate. In all 4 cases, dermoscopy showed a whitish plaque with comedolike openings in the center of the lesion, and a diagnosis of extragenital LS was made. The lesions shown in Figures 1, 2, 3, and 4 are from the back of a 60-year-old woman, a 58-year-old woman, and a 46-year-old woman and from the dorsum of the left foot of a 54-year-old woman, respectively. The lesions that demonstrated an erythematous halo, which is a marker of activity in LS, had well-demarcated borders (Figure 4), whereas those without the halo had more diffuse and ill-defined margins. The comedolike openings and the whitish areas correlated with the histopathologic findings of follicular plugging and the atrophy of the epidermis, respectively. In our opinion, early lesions of LS are associated with dermoscopic features suggestive of follicular plugging (as noted in Figures 1, 2, and 4). With time, these features may become less prominent (Figure 3).