Lichen sclerosus et atrophicus co-existing with localized scleroderma：a case report and literature review

RAN Li-wei; LAN Dong; JIA Hong-xia

doi:10.11786/sypfbxzz.1674-1293.20160301

Abstract：ObjectiveTo investigate the clinical manifestations, pathological features and diagnosis of lichen sclerosus et atrophicus (LSA) co-existing with localized scleroderma (LoS), so as to raise the awareness of the disease and better understand the spectrum of scleroderma. MethodsA case of LSA co-existing with LoS was reported. The clinical data and histopathological features of the case were analyzed. The relevant literatures were reviewed while the discussions were conducted.ResultsThe patient was introduced to our department because of a more than 5-year history of progressive increasing skin lesions over the whole body which without pain or itch. Two years ago, the patient was ifrst diagnosed as LSA in our department. The skin lesions responded poorly to treatment, which progressively increased and became harden. In the last visit, physical examination showed separate or dense, from millet to soybean in diameter, porcelain white, slightly sheen and flat papules which partially atrophied and harden over the trunk and extremities; sheet or band-like, dark red and sclerous patches on which porcelain white and lfat papules could be seen over the extremities, left hand and foot. In the ifrst visit, the histopathology of the skin lesions on the back showed correspondence to diagnosis with LSA. In the last visit, the histopathology of the skin lesions on the left calf showed correspondence to diagnosis with LSA co-existing with scleroderma. According to the clinical data and histopathological features, the patient was diagnosed as LSA co-existing with LoS.ConclusionThe clinical processes, clinical manifestations and pathological features of the case more clearly indicated that scleroderma might be a spectrum of disorder and perhaps LSA could be considered as superifcial scleroderma.