A study of autoimmune related phenomena in 350 women with histologically confirmed lichen sclerosus et atrophicus revealed that 21.5% had one or more autoimmune related diseases, 21% had one or more first degree relatives with an autoimmune-related disease, 42% had an autoantibody at a titre greater than 1:20, and 59.5% had one or more of these autoimmune-related phenomena. No statistically significant differences in the natural history of lichen sclerosus et atrophicus were demonstrated between those patients with autoimmune-related phenomena and those without.

Summary In 1969 an apparently unique patient with myasihenia gravis alopecia and an associated widespread hair follicle hamartoma was reported by Brown, Crounse & Winkelmann (1969). We describe here a case which shows striking clinical and pathological similarities 10 that original patient.

Patients and Methods201 women with anogenital dermatoses were referred to our contact dermatitis clinic over 14 years: Ill had a diagnosis of eczema, in 44 the diagnosis was unknown and in 46 the diagnosis was one of the following; psoriasis, lichen planus, vestibulitis or lichen sclerosus. 103 had a dermatosis only involving the vulva, 42 had perianal involvement only, and 56 had dermatoses involving both sites.They were tested against the European standard series, a medicament series, a corticosteroid series and their own topical medicaments. Other specific allergens were tested where relevant. Patches were removed and read at 2 days and again at 4 days.

An underlying skin disorder prior to the development of their carcinoma was found in 22 of 23 patients with vulval SCC and is therefore an important risk factor.

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