Increase of elastic fibers in lichen sclerosus et atrophicus

Abstract

An increase in elastic fibers in the mid to lower dermis may reflect a repairing process in response to the degraded upper dermal elastic fibers, which could be related to the pathogenesis of LSA.

Acquired elastotic hemangioma‐like changes and eccrine sweat duct squamous metaplasia in lichen simplex chronicus/prurigo nodularis‐like lesions of the knee and elbow

“…In 3 cases, a massive increase in elastic fibers in the mid and lower dermis beneath the vascular alteration contrasted strikingly with their near absence in the superficial subepithelial tissue, as revealed by special elastic stains. A similar histological finding has been described in lichen sclerosus et atrophicus of the vulva and penis manifesting a very distinctive sandwich‐like pattern composed of the epithelium (normal or dysplastic), subepithelial homogenized and sclerotic area, and sharply demarcated deeper elastosis . It is obvious that the most common mechanism of elastic fiber alteration in the skin, that is chronic or longstanding sun exposure can be excluded in these anatomic areas (vulva and penis).…”

“…47,48 Syringomatous changes of eccrine sweat glands have been documented in PN. 43 49,50 It is obvious that the most common mechanism of elastic fiber alteration in the skin, that is chronic or longstanding sun exposure can be excluded in these anatomic areas (vulva and penis). The lesions we report on were located on the elbow and knee representing locations where the possibility of sun exposure cannot be totally discarded but it is highly possible that some other unknown factors can play a role in the pathogenesis of elastic tissue changes, such as a consequence of the production of elastolytic enzymes in the dermis.…”

Lichen sclerosis: clinicopathological study of 60 cases from Lebanon

“…Elastic fiber alterations have also been the focus of several studies on LS. While some demonstrated the presence of a hybrid elastocollagenous mass as the main constituent of the homogenized zone or an increase in elastic fibers in the mid to deep dermis, the most frequent microscopic finding in LS is elastic tissue loss in the papillary dermal homogenized zone . This finding, which was observed in 38.5% of our cases, can serve as a distinguishing feature from lichen planus and morphea .…”

Polarized Microscopy in Lesions With Altered Dermal Collagen

“…Preservation of elastic fibers was reported in morphea in a parallel arrangement between thickened collagen fibers, 17 whereas LS demonstrated preservation of elastic fibers in mid and lower dermis compared with superficial hyalinized dermis which demonstrated absent elastic fibers. 18 Structural differences in hypertrophic scar and keloid were noted under polarized microscopy. Hypertrophic scars are raised scars confined to the original wound edge, unlike keloid where extension beyond wound edges is noted.…”