Korean J Dermatol.
2008 Jan;46(1):15-25.
A Clinical and Histopathologic Study of Lichen Sclerosus et Atrophicus
- Affiliations
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- 1Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. miumiu@amc.seoul.kr
Abstract
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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 1:20, 1:3 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).