Humans ; Lichen Sclerosus et Atrophicus/diagnosis* ; Skin

BACKGROUND: Differential diagnosis of lichen sclerosus et atrophicus( SA) and scleroderma is occasionally difficult. OBJECTIVE: The purpose of this study was to attempt differentiation between the two diseases using imrnunohistochemical stain and lectins. MEHTODS: Paraffin-embeddred sections of 4 cases of LSA and 11 cases of scleroderma were evaluated for this study. Using lectins, such as peanut agglutinin(PNA), siybean agglutinin(SBA), Ulex europaeus agglutinin-I(UEA-I) and Dolichos biflorus agglutinin(DBA) and the avidin-biotin-peroxi-dase complex(ABC) technique, differential lectin binding patterns betv een the two diseases were examined. RESULTS: In the case of LSA, PNA and SBA stained the upper and lower spinous layer of the epidermis, and UEA I also stained the spinous layer of the epidermis weakly, but no DBA was stained. In the case of scleroderma, PNA stained not only the spinous layer but also the basal layer, SBA stained the upper half of the spinous layer but not the lower half of the pinous layer of epidermis. But UEA-I stained the vascular endothelial cells of dermis instead of epidermis, and DBA stained only the basal layer of epidermis. CONCLUSION: Staining of these 4 lectins on paraffin-embedded sectians using ABC teehnique could be helpful in differenting LSA and scleroderma.
Dermis ; Diagnosis, Differential ; Dolichos ; Endothelial Cells ; Epidermis ; Lectins* ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Ulex

Male genital lichen sclerosus (MGLSc) is a chronically relapsing disease characterized by a long course, gradual aggravation, and a tendency towards malignancy. Once called balanitis xerotica obliterans, MGLSc has a distinct predilection for the prepuce and glans, involving the urethra when aggravating, forming scarring tissues, and causing urethral stricture, which may seriously affect the patients'quality of life with such symptoms as urinary stream narrowing, dysuria, and painful penile erection. The etiology and pathogenesis of MGLSc have not yet been adequately explained though it is generally thought to be associated with autoimmune mechanism, genetic factors, infections, local trauma, and chronic urinary irritation. MGLSc can be fairly easily diagnosed according to its clinical manifestations and histopathological results, but can be hardly cured. Early diagnosis and prompt treatment are the most important approaches, which may relieve its symptoms, check its progression, and prevent its long-term sequelae. Ultrapotent topical corticosteroids are the choice for the treatment of MGLSc. For those who fail to respond to expectant medication or have dysuria due to urethral stricture and painful erection, rational surgery may be resorted to, with importance attached to long-term follow-up. This article presents an update of the diagnosis and treatment of MGLSc and MGLSc-induced urethral stricture.
Genital Diseases, Male ; diagnosis ; etiology ; therapy ; Humans ; Lichen Sclerosus et Atrophicus ; complications ; diagnosis ; therapy ; Male ; Urethral Stricture ; etiology

Lichen sclerosus et atrophicus (LSA) is a benign, chronic inflammatory mucocutaneous disease of unknown etiology with a predilection for the female genital area, which is highly bothersome. It may also involve other areas, mainly the upper trunk, axillae and buttocks and clinicians often make a misdiagnosis of these extragenital lesions due to their rarity and lack of symptoms. We herein report the case of a 69-year-old female patient with multiple extragenital LSA presenting with hemorrhagic change. Histopathologic evaluation showed follicular plugging, atrophy of stratum malpighii with hydropic degeneration of basal cells, prominent upper dermal edema and lichenoid lymphocytic infiltration in the mid dermis which was consistent with LSA. We remind clinicians of including LSA in the differential diagnoses of multiple cutaneous hemorrhagic lesions.
Aged ; Atrophy ; Axilla ; Buttocks ; Dermis ; Diagnosis, Differential ; Diagnostic Errors ; Edema ; Female ; Hemorrhage ; Humans ; Lichen Sclerosus et Atrophicus ; Lichens

Lichen sclerosus et atrophicus is a benign, chronic inflammatory dermatosis with multifactorial origin. It is most common in the vulvar and perianal areas, but it may involve any other area, rarely face, oral mucosa, and palm and sole. Especially, lichen sclerosus et atrophicus on face is more difficult in diagnosis due to atypical location and may be confused with morphea, discoid lupus erythematosus, vitiligo, and atophic scar. We, herein, present a case of facial lichen sclerosus et atrophicus with central brownish atrophic change in a 21-year-old man. The lesion showed atypical clinical feature and unusual location. But histologic examination revealed typical features of lichen sclerosus et atrophicus.
Cicatrix ; Diagnosis ; Humans ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Lupus Erythematosus, Discoid ; Mouth Mucosa ; Scleroderma, Localized ; Skin Diseases ; Vitiligo ; Young Adult