Lichen sclerosus and morphea

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 Authored by: Sabine Ludwig     ·  Aimilios Lallas

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Author(s) Sabine Ludwig · Aimilios Lallas
Responsible author Aimilios Lallas→ send e-mail
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Status update July 12, 2017
Status by Ralph P. Braun


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Lichen sclerosus and morphea

The predominant dermoscopic feature of lichen sclerosus are white-yellowish structureless areas, independently of the location. Genital lichen sclerosus commonly appear with linear vesselsLinear mildly curved vessels considered irregular when different sizes shapes and curves with a haphazard or random distribution are presented and considered regular when short and fine (thin) linear vessels prevail various diagnoses while extragenital lesions rather exhibit keratotic plugs, surrounded by an erythematous halo. This halo represents a marker of disease activity.[1][2] In morphea, linear vessels within the lilac ring are a typical finding in dermoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections..[3]

By dermoscopical examination, lichen sclerosus is typified by comedo-like openings[[Comedo like openings]] and whitish patches, whereas morphea exhibits fibrotic beams.[4]
  1. Larre Borges et al.: Clinical, dermoscopic and histopathologic features of genital and extragenital lichen sclerosus. J Eur Acad Dermatol Venereol 2013;27:1433-9. PMID: 22646723. DOI.
  2. Garrido-Ríos et al.: Dermoscopy of extragenital lichen sclerosus. Arch Dermatol 2009;145:1468. PMID: 20026867. DOI.
  3. Vázquez-López et al.: Dermoscopic semiology: further insights into vascular features by screening a large spectrum of nontumoral skin lesions. Br. J. Dermatol. 2004;150:226-31. PMID: 14996092.
  4. Shim et al.: Diagnostic usefulness of dermatoscopy in differentiating lichen sclerous et atrophicus from morphea. J. Am. Acad. Dermatol. 2012;66:690-1. PMID: 22421117. DOI.