Increase of elastic fibers in lichen sclerosus et atrophicus.

BACKGROUND: Lichen sclerosus et atrophicus (LSA) is histopathologically characterized by upper dermal hyalinization with vacuolar alteration, whereas no particular microscopic change in the mid to lower dermis has been described. The purpose of this study was to investigate any histopathologic changes involving elastic fibers in the mid to lower dermis in patients with LSA. METHODS: We surveyed 22 paraffin-embedded specimens of vulval (18 cases) and extragenital (4 cases) LSA. The sliced skin sections were stained with elastic van Gieson (EVG), and then the degree of elastic fiber change was determined. RESULTS: We found an increase in elastic fibers in the mid to lower dermis in contrast to a decrease or disappearance of elastic fibers in the superficial hyalinized dermis. The level of increase of elastic fibers varies from normal (8/22 cases) to moderate (7/22 cases) to advanced (7/22 cases) levels. CONCLUSIONS: An increase in elastic fibers in the mid to lower dermis may reflect a repairing process in response to the degraded upper dermal elastic fibers, which could be related to the pathogenesis of LSA.