Al-Husain Khalid M, Madani Abdulaziz, Alhumidi Ahmed, Alsehli Turky, Nagshabandi Khalid Nabil
Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Clin Cosmet Investig Dermatol. 2024 Jul 10;17:1633-1636. doi: 10.2147/CCID.S471363. eCollection 2024.
Lichen sclerosus is a chronic inflammatory dermatological condition of unknown etiology, primarily impacting the genital epidermis in individuals of all genders, with a higher prevalence observed among postmenopausal women and prepubescent girls. Additionally, extragenital manifestations occur in approximately 20% of the patients diagnosed with genital lichen sclerosus. Notably, folliculocentric extragenital lichen sclerosus is rare and unusual, with only limited instances documented in existing literature.
We report a 33 years old lady presented with multiple asymptomatic lesions on the dorsal feet for 1 year and similar lesions on the left hand for 4 months. On examination: folliculocentric, shiny, atrophic papules coalescing into reticulated plaques over the dorsum of both feet and few shiny, flat-topped, pink papules over the dorsum of the left hand. A skin biopsy was performed and confirmed the diagnosis of extragenital lichen sclerosus.
Acral folliculocentric extragenital lichen sclerosus is an unusual and rare clinical variant. Clinicopathologic correlation is necessary to establish the correct diagnosis.
Herein, we present an unusual presentation of extragenital lichen sclerosus, and we highlight the importance of considering it in the differential diagnosis of guttate acral skin lesions. We also review and summarize relevant cases from the literature in hope to aid physicians, especially dermatologists, to consider and swiftly reach the diagnosis and offer appropriate management. We also hope to bring about new insights and broaden future research efforts regarding lichen sclerosus especially and atrophic skin disease in general.
硬化性苔藓是一种病因不明的慢性炎症性皮肤病，主要影响所有性别的个体的生殖器表皮，在绝经后女性和青春期前女孩中患病率较高。此外，约20%被诊断为生殖器硬化性苔藓的患者会出现生殖器外表现。值得注意的是，以毛囊为中心的生殖器外硬化性苔藓罕见且不常见，现有文献中记载的病例有限。
我们报告一名33岁女性，背部足部出现多个无症状皮损1年，左手出现类似皮损4个月。检查发现：以毛囊为中心、发亮、萎缩性丘疹融合成网状斑块分布于双足背部，左手背部有少量发亮、平顶、粉红色丘疹。进行了皮肤活检，确诊为生殖器外硬化性苔藓。
肢端毛囊中心性生殖器外硬化性苔藓是一种不寻常且罕见的临床变异型。临床病理相关性对于确立正确诊断很有必要。
在此，我们展示了生殖器外硬化性苔藓的一种不寻常表现，并强调在点滴状肢端皮肤病变的鉴别诊断中考虑该病的重要性。我们还回顾并总结了文献中的相关病例，希望帮助医生，尤其是皮肤科医生，考虑并迅速做出诊断并提供适当的治疗。我们也希望能为硬化性苔藓尤其是萎缩性皮肤病带来新的见解并拓宽未来的研究方向。
