Lichen Sclerosus et Atrophicus in a Vaccination Site

To the Editor.—  Lichen sclerosus et atrophicus (LSA) is a skin disease that begins as papules that may coalesce to form plaques and eventually become atrophic white spots.¹ Although reports of verrucous plaques have been noted,² this is uncommon. We report the following case to emphasize this unusual clinical presentation and to document the occurrence in a vaccination site.

Report of a Case.—  A 13-year-old girl was seen on May 21, 1975, for evaluation of her vaccination site. She had been vaccinated at age 2 years and revaccinated at age 6 years. The initial lesion appeared a few months following revaccination and remained unchanged until two years prior to evaluation, when it enlarged and several discrete but similar new lesions appeared.

Physical Examination.—  Four discrete, elevated, verrucous hyperpigmented plaques were distributed over the left deltoid area. The largest annular lesion measured 3 cm in diameter and surrounded an