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 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.