Lymphocytes and some plasma cells are concentrated in the subepidermis. Mixed Lichen Sclerosis and Squamous Cell Hyperplasia Often see LS which has focal SCH due to constant scratching inducing focal hyperplasia. Any atypia is reported separate from the non-neoplastic component, and moves the lesion into the VIN category, out of dystrophy. Must ablate these lesions and follow to rule out recurrence. Sweat retention, and possible urine retention may be most common cause of irritation.
Secondary infection is common.
May see family history of this. While usually extensor surfaces, skin flezxures can be affected too. Sometimes genitals are the only site, usually not. Starts as papules enlatrgine into plaques, but mucous membranes are usually unaffected. See fine silvery scaling, but possible minimal scaling and more seborrheic.