Lichen atrophicus et atrophicus is a chronic inflammatory skin condition. It usually involves the anogenital skin of postmenopausal women but can involve extragenital skin.
Clinical features:
(1) pruritis, which may be severe
(2) epidermal atrophy
(3) dermal sclerosis with whitish skin color
A biopsy of early disease is nonspecific with chronic inflammatory cell infiltrate. Over time there is thinning of the epidermis and dense sclerosus of the dermis.
Diagnosis in an extragenital site is usually easier if the patient has anogenital lichen sclerosus (balanitis xerotica obliterans in the male).
Distribution:
(1) acral pattern (hands and feet)
(2) neck, shoulder and trunk
(3) mucosal
Types:
(1) disseminated
(2) bullous
(3) nail dystrophy
Differential diagnosis:
(1) lichen planus (both lichen planus and lichen sclerosus can occur in the same patient)
(2) scleroderma
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