Early lichen sclerosus and lichen planus of the vulva may resemble each other clinically. Fung and LeBloit describe histologic features which may help separate the two conditions.


Features seen only in lichen sclerosus:

(1) basilar epidermotropism

(2) basement membrane thickening

(3) epidermal atrophy


Features favoring lichen sclerosus:

(1) psoriasiform lichenoid pattern (elongation of rete ridges with rounded edges)

(2) loss of papillary dermal elastic fibers


Features favoring lichen planus:

(1) wedge-shaped hypergranulosis

(2) basal squamatization

(3) pointed rete ridges


Features seen only in lichen planus:

(1) many cytoid bodies



• A cytoid body is also known as an apoptotic, hyaline, civatte or colloid body.

• Basilar epidermotropism describes the presence of lymphocytes in the basal layers of the epidermis. Although the Fung et al describe it only with lichen sclerosus, Hood and Farmer describe it as a common feature of lichen planus in extragenital sites. I wonder if it is as specific as suggested by the authors.

• For the implementation I made a score with 2 points for each specific and 1 point for each favorable feature. I gave only 1 point to basilar epidermotropism.


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