A Clinical and Histopathologic Study of Lichen Sclerosus et Atrophicus / 대한피부과학회지

ABSTRACT

BACKGROUND: Lichen sclerosus et atrophicus (LS et A) is an uncommon chronic lymphocyte-mediated dermatosis that causes substantial discomfort and morbidity, most commonly in adult women. It occurs predominantly in the anogenital area, and extragenital lesions also occur. OBJECTIVE: The aim of this study is to compare clinical and histopathologic features of genital and extragenital LS et A. METHODS: We retrospectively reviewed the medical records and 31 biopsy specimens of 29 patients who had been diagnosed with LS et A between January 2001 to June 2007 in Asan Medical Center. RESULTS AND CONCLUSION: The male to female ratio of genital LS et A and extragenital LS et A was 120, 13 respectively. Mean age at onset of genital LS et A and extragenital LS et A was 47.8 and 36.9 respectively. The color of the lesions was mostly white, irrespective of the involved area. Genital LS et A lesions were mostly located on labium majora or minora. Extragenital LS et A lesions were mostly located on the trunk, head and neck. The predominant symptom for genital LS et A was pruritus, whereas extragenital LS et A was mostly asymptomatic. The main treatment regime of LS et A was topical corticosteroid. The combination therapy with topical corticosteroid and pimecrolimus/tacrolimus resulted in symptomatic relief as well as improvement of skin lesions, without significant side effect. Histopathologically all LS et A cases showed vacuolar alteration, papillary dermal hyalinization, and dermal lymphohistiocytic infiltration. Hypergranulosis, exocytosis, red blood cell extravasation, lichenoid inflammatory cell infiltration were more frequently observed in genital LS et A (p<0.05). Follicular plugging, epidermal atrophy and loss of rete ridges were more frequently observed in extragenital LS et A (p<0.05).