Bullous and hemorrhagic lichen sclerosus - Case report

Abstract

Lichen sclerosus is a chronic inflammatory disease, usually located in the genital area. The etiology of lichen sclerosus is multifactorial, with participation of genetic, autoimmune, infectious and hormonal factors. Bullous clinical form stems from hydropic degeneration of the basal membrane, constituting a less frequent variant of the disease. In this work, we report the case of a female patient, 55 years old, who in the last three years presented whitish plaques, with horny spikes, located on back and arms. Some of these lesions evolved with hemorrhagic blisters, which after histopathological examination confirmed the diagnosis of bullous and hemorrhagic lichen sclerosus. The patient was treated with high-potency topical corticosteroid for two months, resulting in remission of bullous and hemorrhagic lesions.

Acral bullous lichen sclerosus intolerant to UVA‐1 successfully treated with narrowband ultraviolet B phototherapy

“…Recommendations are primarily based on small uncontrolled studies and case reports. Superpotent topical corticosteroids are the first‐line therapy, although they may be less effective than for genital lesions . Other topical treatments include retinoids and calcineurin inhibitors.…”

“…Other topical treatments include retinoids and calcineurin inhibitors. Systemic immunosuppressive therapies such as methotrexate have been used with variable outcomes …”

“…The most frequent clinical variant of the disease presents with porcelain white, pruritic, and atrophic plaques on the genitalia . Extragenital LS occurs in only 15%‐20% of patients, and palmar/plantar involvement is exceedingly rare . The flattened interface between the epidermis and dermis results in fragility of the dermo‐epidermal junction; thus, lesions may be occasionally complicated with bullae.…”

“…1 Extragenital LS occurs in only 15%-20% of patients, and palmar/plantar involvement is exceedingly rare. 2,3 The flattened interface between the epidermis and dermis results in fragility of the dermo-epidermal junction; thus, lesions may be occasionally complicated with bullae. Acral bullous LS may be a chronic, progressive, and difficult-to-treat entity.…”

Extragenital bullous and hemorrhagic Lichen sclerosus in a 58-year-old woman - A case report

“…The disease affects both genders with female/male ration of 10:1 and is diagnosed in 5 to 6 decade of life. The frequency of extragenital location is reported to be 15-20% [2]. The etiology is an object of broad discussions and the role of genetic factors, autoimmunity, hormonal disturbances due to thyroid pathology and infections pathogens, like Borrelia burgdorferi and Hepatitis C virus have been investigated [4,5].…”