Lichen Sclerosus et Atrophicus

A 48-year-old male patient had white to ivory colored patches on brown colored bases over the right side of his back for 8 years without accompanying pruritus or pain. Six months prior to the onset of his skin eruption, he received acupuncture for the relief of right sided back pain for 1 month. Histopathologic examination of the white patches showed follicular plugging, epidermal atrophy, focal hydropic degeneration of basal cells, lymphedema of papillary dermis, thickened homogenization of collagen fibers; consistent with findings previously reported in lichen sclerosus et atrophicus. We report this case to document the occurence in an acupuncture site and stress the unusual clinical manifestation of a zosteriform distribution.