A Case of Lichen Sclerosus et Atrophicus Accompanying Bullous Morphea

Abstract

Bullous morphea is a rare form of morphea characterized with bullae on or around atrophic morphea plaques. Whereas lichen sclerosus et atrophicus (LSA) is a disease the etiology of which is not fully known, and which is characterized with sclerosis. Coexistence of morphea and LSA has been identified in some cases. Some authors believe that these two diseases are different manifestations which are on the same spectrum. The 70-year-old patient stated herein, presented to us for 6 months with annular, atrophic plaques, ivory color in the middle, surrounded by living erythema, on the front and back of the trunk. Occasionally bulla formation on the plaques on the trunk lateral was identified. Fibrotic and atrophic plaques of ligneous hardness were present on the front side of tibia of both legs. In the histopathologic examination, the lesions were found concordant with bullous morphea and LSA. With colchicine 1.5 mg/day, pentoxifylline 1,200 mg/day, topical calcipotriol ointment and clobetasol propionate cream, the erythema in the patient's lesions faded and softening in the fibrotic plaques was observed. Concomitance of bullous morphea and LSA is a rarely seen, interesting coexistence which suggests a common, as yet unknown, underlying pathogenesis.