Skip to main content
Log in

Lichen sclerosus et atrophicus. A histological, immunohistochemical and electron microscopic study

  • Original Contributions
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

We studied three cases of genital lichen sclerosus et atrophicus (LSA) using histological, immunohistochemical and ultrastructural techniques to elucidate the characteristics of the collagen fibres, the elastic fibres and the interfilamentous matrix in the upper dermal homogeneous zone. In the early stages of LSA, the homogeneous zone caused elaunin fibres to push downwards and partially disappear, the collagen fibres were presumably phagocytosed by fibroblasts, and there were peculiar cells containing numerous vacuoles in the cytoplasm. In the advanced stages of LSA, the homogeneous zones showed newly formed collagen fibres and amorphous, dispersed, medium electron-dense substances that were probably composed of elastin or elastin-like substances and microfilaments originating from the collagen fibres. Immunohistochemically, there were numerous anti-aortic alpha-elastin-positive substances, but there was no positivity for anti-amyloid P component. These findings suggest that in advanced LSA a hybrid substance (elastocollagenous mass) between collagen fibres and elastic fibres may be formed in the homogeneous zone.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Balus L (1971) Lichen sclerosus et atrophicus der Vulvagegend als prÄcanceröser Zustand. Hautarzt 22: 199–203

    Google Scholar 

  2. Breathnach SM, Melrose SM, Bhogal B, et al. (1983) Immunohistochemical studies of amyloid P component distribution in normal human skin. J Invest Dermatol 80: 86–90

    Google Scholar 

  3. Bushkell LL, Friedrich EG Jr, Jordan RE (1981) An appraisal of routine direct immunofluorescence in vulvar disorders. Acta Derm Venereol (Stockh) 61: 666–668

    Google Scholar 

  4. Carli P, Cattaneo A, Pimpinelli N, Cozza A, Bracco G, Giannotti B (1991) Immunohistochemical evidence of skin immune system involvement in vulvar lichen sclerosus et atrophicus. Dermatologica 182: 18–22

    Google Scholar 

  5. Cotta-Pereira G, Rodrigo FG, Bittencourt-Sampaio S (1976) Oxytalan, elaunin, and elastic fibers in the human skin. J Invest Dermatol 66: 143–148

    Google Scholar 

  6. Forssmann WS, Holzmann H, Cabré J (1964) Elektronenmikroskopische Untersuchungen der haut beim Lichen sclerosus et atrophicans. Arch Klin Exp Dermatol 220: 584–599

    Google Scholar 

  7. Frances C, Wechsler J, Rouges O (1981) Lichen scleroatrophique vulvaire (L. S. A. V.); etude biochimique, histologique, ultrastructurale et immunologique (abstract). Ann Dermatol Venereol 108: 209

    Google Scholar 

  8. Frances C, Wechsler J, Meimon J, Labat-Robert J, Grimaud JA, Hewitt J (1983) Investigation of intercellular matrix macromolecules involved in lichen sclerosus. Acta Derm Venereol (Stockh) 63: 483–490

    Google Scholar 

  9. Godeau G, Frances C, Hornebeck W, Brechemier D, Robert L (1982) Isolation and partial characterization of an elastase-type protease in human vulva fibroblasts: its possible involvement in vulvar elastic tissue destruction of patients with lichen sclerosus et atrophicus. J Invest Dermatol 78: 270–275

    Google Scholar 

  10. Griffiths MR, Priestley GC (1992) A comparison of morphea and lichen sclerosus et atrophicus in vitro: the effects of paraaminobenzoate on skin fibroblasts. Acta Derm Venereol (Stockh) 72: 15–18

    Google Scholar 

  11. Hall DA, Keech KM, Reed R, Saxl H, Tunbridge ER, Wood MJ (1955) Collagen and elastin in connective tissue. J Gerontol 10: 388–400

    Google Scholar 

  12. Hart WR, Norris HJ, Helwig EB (1975) Relation of lichen sclerosus et atrophicus of the vulva to the development of carcinoma. Obstet Gynecol 45: 369–377

    Google Scholar 

  13. Kajikawa K, Yamaguchi T, Katsuda S, Miwa A (1975) An improved electron stain for elastic fibers using tannic acid. J Electron Microsc (Tokyo) 24: 287–289

    Google Scholar 

  14. Kint A, Geerts ML (1975) Lichen sclerosus et atrophicus. An electron microscopic study. J Cutan Pathol 2: 30–34

    Google Scholar 

  15. Kishimoto S, Uyeda K, Matsuki M (1975) Genital cancer associated with lichen sclerosus et atrophicus. (in Japanese). Rinsho Hifuka 29: 677–684

    Google Scholar 

  16. Klug VH, Sönnichsen N (1972) Elektronenoptische Untersuchungen bei Lichen sclerosus et atrophicus. Dermatol Monatsschr 158: 641–654

    Google Scholar 

  17. Kobori T, Amatani H, Kumakura K (1963) Two cases of lichen sclerosus et atrophicus (abstract in Japanese). Nippon Hifuka Gakkai Zasshi 73: 241

    Google Scholar 

  18. Mann PR, Cowan MA (1973) Ultrastructural changes in four cases of lichen sclerosus et atrophicus. Br J Dermatol 89: 223–231

    Google Scholar 

  19. Mehregan AH, Hashimoto K (1991) Lichen sclerosus et atrophicus.In: Pinkus' guide to dermatohistopathology, 5th edn. Appleton & Lange, Prentice-Hall International, East Norwalk, pp 357–358

    Google Scholar 

  20. Miller RF (1957) Lichen sclerosus et atrophicus with oral involvement: histopathologic study and dermabrasive treatment. Arch Dermatol 76: 43–55

    Google Scholar 

  21. Mon tgomery H, Hill WS (1940) Lichen sclerosus et atrophicus. Arch Dermatol Syph 42: 755–779

    Google Scholar 

  22. Patterson JAK, Ackerman AB (1984) Lichen sclerosus et atrophicus is not related to morphea. A clinical and histologic study of 24 patients in whom both conditions were reputed to be present simultaneously. Am J Dermatopathol 6: 323–335

    Google Scholar 

  23. Rahbari H (1989) Histochemical differentiation of localized morphea-scleroderma and lichen sclerosus et atrophicus. J Cutan Pathol 16: 342–347

    Google Scholar 

  24. Romppanen U, Rantala I, Lauslahti K, Reunala T (1987) Light- and electron-microscopic findings in lichen sclerosus of the vulva during etretinate treatment. Dermatologica 175: 33–40

    Google Scholar 

  25. Schwarz W (1964) Elektronenmikroskopische Untersuchungen über die Bildung elastischer Fasern in der Gewebekultur. Z Zellforsch [A] 63: 636–643

    Google Scholar 

  26. Steigleder GK, Raab WP (1961) Lichen sclerosus et atrophicus. Arch Dermatol 84: 219–226

    Google Scholar 

  27. Suurmond D (1964) Lichen Sclerosus et atrophicus of the vulva. Arch Dermatol Syph 90: 143–152

    Google Scholar 

  28. Uitto J, Santa Cruz DJ, Bauer EA, Eisen AZ (1980) Morphea and lichen sclerosus et atrophicus: clinical and histopathologic studies in patients with combined features. J Am Acad Dermatol 3: 271–279

    Google Scholar 

  29. Uitto J, Fazio M, Bashir M, Rosenbloom J (1991) Elastic fibers of the connective tissue. In: Goldsmith LA (ed) Physiology, biochemistry, and molecular biology of the skin, 2nd edn. Oxford University Press, New York, pp 530–557

    Google Scholar 

  30. Wenstrup RJ, Murad S, Pinnell SR (1991) Collagen. In: Goldsmith LA (eds) Physiology, biochemistry, and molecular biology of the skin, 2nd edn. Oxford University Press, New York, pp 481–508

    Google Scholar 

  31. Yoshima H, Shinkai H, Sano S, Homma M (1978) Acidic glycosaminoglycans in skin and urine of a patient with widespread lichen sclerosus et atrophicus. Arch Dermatol Res 263: 59–66

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mihara, Y., Mihara, M., Hagari, Y. et al. Lichen sclerosus et atrophicus. A histological, immunohistochemical and electron microscopic study. Arch Dermatol Res 286, 434–442 (1994). https://doi.org/10.1007/BF00371568

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00371568

Key words

Navigation