Lichen sclerosus pathology

Histology lichen sclerosus

The scanning power of lichen sclerosus reveals a lichenoid inflammatory pattern in early stage lesions or superficial sclerosing process in late stage lesions (Figures 1 and 2). the epidermis shows hyperkeratosis, significant weight loss with loss of normal challenge crest and plugging pattern follicular infundibulae (Figure 3). A atrophic the epidermis is not a requirement since some cases particularly in vulva can show significant epidermal hyperplasia. Vacuolar degeneration of the basal cap It can be seen, although typically mild, especially in late stage injuries. Cleft may be evident between the epidermis and dermis as a result of this degeneration of the basal layer and the underlying dermal Changes The dominant feature is the wide condensation of the dermis. collagen. These changes are typically superficial, whereas in early lesions they may show marked overlying papillary dermal edema. When it extends into the deep dermis, discrimination of scleroderma It can become difficult. The inflammatory infiltrate evolves from a dense lichenoid lymphocytic infiltrate a shallow scarce interstitial infiltrate the late stage of the disease. Scattered plasma cells, histiocytes and mast cells can be seen (Figure 4).

Differential diagnosis lichen sclerosus pathology

Scleroderma: In this condition, the overlying epidermis and superficial dermis are preserved. Inflammatory infiltrate is typically sparse and deep attached and vascular Structures Overlap can occur where deep and superficial changes coexist.

Lichen planus: the presence of a well-formed granular layer and numerous cytoid bodies, and a lack of thickening of the basement or epidermal membrane atrophy favor lichen planus over lichen sclerosus.