Lichen sclerosus et atrophicus is a rare disease of the skin usually occurring on the upper portions of the trunk, neck, axillae, and forearms, but also found limited to the vulva and/or anus. Hallopeau,1 in 1887, described the first case and called it lichen planus atrophicus. Since then, much has been written about it, and different names have been used to describe what is essentially the same disease or variants of it.2
The disease is characterized by irregular, often polygonal, flat-topped, white papules (ivory or mother-of-pearl whiteness), which may fuse, forming plaques retaining the outlines of the papules. Comedo-like plugs, or bead-like depressions, the former sites of plugs, are common. In the stages of involution, a white parchment-like, or tissuepaper-like, wrinkling is seen. Females are affected about 6 times as frequently as males and usually in the later decades of life. Pruritus is usually present, and periods of