Concomitance of lichen sclerosus et atrophicus and morphea in the same lesions

A 65-year-old woman presented atrophic, slightly indurated plaques on the trunk and a sclerotic, hemorragic plaque on the right forearm. In three biopsies, diagnostic features of both lichen selerosus et atrophicus (LSA) and morphea coexisted. Elastic fibers were absent in the papillary dermis and present in the sclerotic reticular dermis. Although many patients with lesions of both morphea and LSA have been reported, the coexistence of the two histological features in the same lesion is less frequent.     

Diffuse fasciitis with eosinophilia associated with morphea and lichen sclerosus et atrophicus

Diffuse fasciitis with eosinophilia (DFE) is a well described syndrome, among the connective tissue disorders. However, DFE is not commonly accepted as an own entity, because of its rare evolvement in scleroderma and the often indistinguishable histological pattern of both diseases. Here we report on the association of DFE and morphea in two patients and an additional lichen sclerosus in one of them. This points to a close relationship of DFE and other connective tissue diseases.     

Annular lichen sclerosus et atrophicus

Lichen sclerosus et atrophicus (LSA) is an idiopathic skin condition characterized by ivory-colored, atrophic papules and plaques. Many variants of LSA have been described. Only rarely has an annular variant been noted. We present a case of annular LSA and discuss the other reported cases exhibiting an annular shape.     

Extragenital lichen sclerosus et atrophicus

A 76-year-old woman with a history of eczematous dermatitis presented with a 9-month history of a pruritic, eczematous eruption of the trunk. This eruption responded to topical glucocorticoids but recurred on discontinuation of treatment on multiple occasions. A biopsy specimen showed extragenital lichen sclerosus et atrophicus. The diagnosis of extragenital lichen sclerosus is reviewed with a comparison to classic lichen sclerosus in terms of clinical features, histopathologic characteristics, and treatment approaches.     

Palmo-plantar lichen sclerosus et atrophicus

A case of lichen sclerosus et atrophicus (LSA) in a male patient who presented with multiple hypopigmented to depigmented macules, polygonal in shape, distributed in a bilaterally, symmetrical manner over the hands, feet and flexor aspect of wrists is being reported. Histopathology confirmed the diagnosis of LSA.     

Acral lichen sclerosus et atrophicus

BACKGROUND: Lichen sclerosus et atrophicus rarely affects the feet or hands and in this case, it is generally part of widespread cutaneous involvement. We report a case of lichen sclerosus et atrophicus involving only the extremities and the vulvar and perigenital area. PATIENTS AND METHODS: A 56-year-old woman presented with lesions of the hands and feet, with ivory white papules on the dorsal aspect of the feet and the distal phalanx of the fingers, a few small keratotic papules with central depressions in the hollow of the palms, erythema on soles and thenar and hypothenar eminences. Further examination revealed lichen sclerosus et atrophicus of the vulva and genitocrural skinfolds. Histological study of these various cutaneous lesions yielded similar results and revealed the typical features of lichen sclerosus et atrophicus. DISCUSSION: A few cases of lichen sclerosus et atrophicus confined to the hands and/or feet have been reported, involving the palms and soles or nail folds, but none has so far affected the genitalia. To our knowledge, no cases of lichen sclerosus et atrophicus involving both faces of the hands and feet and the genital region have ever been reported.     

Human papillomavirus infection in vulvar lesions of lichen sclerosus et atrophicus

Summary Human papillomaviruses (HPV) types 6, 11, 16 and 18 infections were investigated in 18 vulvar lesions of lichen sclerosus et atrophicus (LSA) using in situ DNA hybridization and polymerase chain reaction (PCR) on formalin-fixed paraffin-embedded specimens. Four out of 18 specimens were found to be infected with HPV type 16 using the PCR technique. Interestingly, three of these four patients were in a premenopausal state. This difference proved to be the only distinguishing feature in a comparison of HPV type 16-infected patients with non-infected patients. In situ hybridization revealed no positive result in any case and PCR demonstrated no HPV-DNA type 6, 11 or 18. Patients with HPV type 16-infected lesions may be regarded as at risk of developing vulvar cancer. Therefore, long-term follow-up of this subgroup is particularly important.     

Milia occurring in lichen sclerosus et atrophicus

Large numbers of milia were seen in areas of skin affected with bullae in a 68-year-old woman who had extensive lichen sclerosus et atrophicus. Although milia are frequently seen in other sub-epidermal bullous disorders, they have not previously been reported in lichen sclerosus et atrophicus.     

HLA antigens in lichen sclerosus et atrophicus

Several reports have found conflicting data regarding the association between lichen sclerosus et atrophicus (LSA) and HLA types. Association with HLA-A31 and -B40 has been noted, whereas another report found no correlation. We are the first to specifically examine HLA types in white patients in the United States. We have found a significant association between LSA and HLA-A29 and -B44 individually and an even stronger association with the combination of A29 and B44. A review of previous LSA-HLA studies, as well as several reports of HLA typing in familial LSA, is discussed, with consideration given to possible reasons for the discrepancies among the various studies.     

Clinico-histologic spectrum of lichen sclerosus et atrophicus

Report on several clinical and histological variants of lichen sclerosus et atrophicus by means of two cases.     

硬化萎缩性苔藓的病因学研究进展

硬化萎缩性苔藓（LSA）病因尚不清楚,大量研究表明免疫因素、遗传因素、疏螺旋体属的感染、性激素水平及其受体的减少和氧化应激损伤均与该病的发生发展有着密切的关系。     

硬化萎缩性苔藓的免疫学进展

硬化萎缩性苔藓是一种慢性持续性炎症性皮肤病，其发病与自身免疫密切相关，硬化萎缩性苔藓患者皮肤活检组织中存在免疫学改变：血管炎表现，基底膜的不连续性，单克隆T细胞受体Y链重排；外周血中的免疫学改变：CD4^＋CD25^＋调节性T细胞及细胞因子的增多，抗基底膜抗体、抗细胞外基质糖蛋白-1抗体的发现都提示免疫学改变在硬化萎缩性苔藓发生发展中有着重要的作用。     

硬化萎缩性苔藓的治疗进展

硬化萎缩性苔藓(LSA)好发于女性,常见于外阴、躯干上部如胸背部等,反复发作可导致病损部位解剖结构改变、丧失生理功能,甚至诱发癌变.目前,LSA的发病机制尚未完全明确,临床上治疗方法有限,单一的药物治疗可能疗效不佳,而物理治疗尚缺乏大样本临床研究及远期随访.本文综述LSA的药物治疗和物理治疗方面的新进展.