Lichen sclerosus of lips: a clinical and histopathologic study of 27 cases

Abstract

Lip LS is far less symptomatic and destructive with limited dermal sclerosis compared with genital LS. Greater awareness and histologic assessment are essential for diagnosis because of the misleading vitiligoid appearance. "Vitiligoid LS" a superficial variant proposed by Borda can be aptly applied to lip LS. Dermatologists need to be aware of this rarely reported manifestation of LS as it adds to the spectrum of oral lichenoid lesions and lichenoid dysplasia, which are suspected to have a malignant potential.

Vitiligoid variant of lichen sclerosus in young girls with darker skin types

“…The term vitiligoid LS has since been used in a limited number of reports to describe the presentation of oral and anogenital lesions that were clinically suspected to be vitiligo given the significant depigmentation and lack of symptoms but were determined to be LS after histologic review. [2][3][4] Reports of the synchronous onset of LS and vitiligo have supported the relationship between LS and vitiligo. Three case reports describe LS and vitiligo developing concurrently but in distinct skin locations, which is probably why the term vitiligoid LS was not used and the authors instead assigned both diagnoses.…”

“…Although the term vitiligoid LS was coined in 1961, there has been recent interest in the co‐occurrence of LS and vitiligo. The term vitiligoid LS has since been used in a limited number of reports to describe the presentation of oral and anogenital lesions that were clinically suspected to be vitiligo given the significant depigmentation and lack of symptoms but were determined to be LS after histologic review . Reports of the synchronous onset of LS and vitiligo have supported the relationship between LS and vitiligo.…”

“…Depigmented patches as seen in LS and vitiligo characterize the clinical presentation of vitiligoid LS, but it tends to lack the obvious inflammation, atrophy, and sclerosis of typical LS, and symptoms are generally milder and of shorter duration . On histologic evaluation, such lesions are confirmed to be LS based on the presence of a thin band of papillary dermal sclerosis . Borda and colleagues proposed that vitiligoid LS may be unique to darker‐skinned people, which more‐recent reports have supported .…”

“…On histologic evaluation, such lesions are confirmed to be LS based on the presence of a thin band of papillary dermal sclerosis . Borda and colleagues proposed that vitiligoid LS may be unique to darker‐skinned people, which more‐recent reports have supported . Other reports have described a close relationship between the timing and location of LS and vitiligo presentation but do not categorize such lesions as vitiligoid LS, probably because the conditions occur on different areas of the skin in most cases.…”

Oral lichen sclerosus: a systematic review of reported cases and two new cases

“…To the authors’ knowledge, there are only 39 histologically proven reported cases of OLS in the English literature. However, LS affecting the lip may be underreported . OLS is rarely symptomatic but can cause pain, soreness, pruritus, and tightness when opening the mouth .…”