Koebnerization in a Woman with Extragenital Lichen Sclerosus

Lichen sclerosus (LS) is a chronic benign inflammatory disorder of skin and mucosa which affects patients of all age groups, sex and race, particularly caucasian prepubertal girls and postmenopausal women. The etiology of LS is unknown, but it has been suggested that genetic predisposition to inflammatory disorders, immunological constitutions, hormonal influences and local factors might play a role. Extragenital LS are most common on the neck, shoulders and upper portion of the trunk. It is generally asymptomatic, but occasionally pruritic. The Koebner sign is a well-known diagnostic marker in LS. Typical lesions have been noted to occur following surgical operations, infections, rubbing of skin, in old thermal burn scar, sexual abuse and under tight clothing. We describe a 25-year-old Iranian woman presented with a 2-month history of extragenital LS. The multiple classical lesions of disease were presented over her neck, shoulders, upper part of trunk, the medial area of her thighs and feet at the dorsal site. The diagnosis of LS was confirmed by histological findings. Beside LS classical lesions on her back, linear lesions including Koebner phenomenon were observed at the sites of rubbing and itching of skin.