A 67-year-old woman, without remarkable medical or family background, presented with a\n6month history of a pruritic sclerotic lesion on her abdomen. The sclerotic lesion had\nbeen accompanied by a blister on the back of the right foot for 4 months and there had\nbeen no previous trauma. Physical examination revealed several 2-4 cm, ivory colored,\nshiny, sclerotic lesion on the abdomen ()\nand soft plaque on the back of the right foot (). There were no other lesions on her body. An incision-al biopsy specimen\nrevealed hyperkeratosis, atrophy of the epidermis, marked edema in the upper dermis\nresulting in a subepidermal blister and homogenization of collagen in the papillary\ndermis ().\nAfter the diagnosis of Bullous lichen sclerosus et atrophicus was made, we started\ntreatment with topical corticosteroid and achieved stabilization and slight improvement.
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.