Skin nontumor
Lichenoid and interface reaction patterns
Lichen sclerosus et atrophicus
Last author update: 1 August 2011
Last staff update: 5 September 2023 (update in progress)
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PubMed Search: Lichen sclerosus et atrophicus [title]
Table of Contents
Etiology | Clinical features | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Hamodat M. Lichen sclerosus et atrophicus. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorlichensclerosus.html. Accessed September 27th, 2023.
Etiology
- Atrophic, hypopigmented patches or plaques, usually affecting the upper trunk, neck, flexor wrist or anogenital region
- Often women near menopause
- Cause unknown but associated with HLA DQ7 and autoimmune disorders
- Has been described at areas of scars and at sites of radiotherapy
- In girls, may start at an early age with hemorrhagic perianal lesions; associated with constipation; may be mistaken for sexual abuse
- LS may co-exist with lichen planus and morphea or resemble lichen planus (Case Rep Dermatol 2010;2:55)
- Balanitis xerotica obliterans: involvement of glans penis
- Kraurosis: vulvar involvement; important complication is dysplasia / squamous cell carcinoma
Clinical features
- Atrophic, hypopigmented patches or plaques
Microscopic (histologic) description
- Orthokeratotic hyperkeratosis, epidermal atrophy, hydropic degeneration of basal layer, replacement of papillary dermis by edematous, hypocellular, faintly staining band with chronic inflammatory infiltrate
- Early lesions may have lichenoid changes
- Late lesions may have hyalinization
Microscopic (histologic) images
Images hosted on other servers:
Thinned epidermis
with superficial
dermal collagen
homogenization
Differential diagnosis
- Localized scleroderma (morphea)
- Lichen planus: lacks psoriasiform lichenoid pattern, epidermotropism affecting the basal cell layer, basement membrane thickening, foci of epidermal atrophy, and loss of papillary elastic fibers
