A 22-year-old male had atrophic, hypopigmented macules and papules over chest, trunk and lower limbs since 5 months. Dermoscopy revealed WSA, white chrysalis like structures (WCLA) and telangiectasia of different lengths and calibers [Figure and ].\nHistopathology of lesions showed atrophy of the epidermis, hyperkeratosis [], and follicular plugging with basal cell degeneration. [] The dermis showed edema and homogenization of collagen and interstitial and perivascular lymphocytic infiltration [].\nHair, nail, oral, genital mucosa, systemic examination, and blood investigations were within normal limits in all three patients. A diagnosis of extragenital LS was made in all three cases based on clinical features and histopathology.
A 71-year-old Caucasian female patient with no prior history of skin cancer presented with a red, painful, and enlarging plaque on her right breast for several weeks. This lesion has not been treated in the past and she denies genital lesions.\nPhysical exam revealed a hemorrhagic plaque with subtle surrounding atrophic changes on her right medial breast (Figure ). Punch biopsy of the plaque revealed hyperkeratosis with epidermal atrophy, prominent papillary dermal edema with homogenization, and extensive hemorrhage at the dermoepidermal junction, suggestive of LSA (Figure ). Unfortunately, the patient was lost to follow-up and did not receive treatment.