Case Number : Case 2046 - 10 April 2018 Posted By: Uma Sundram

Lichen sclerosus

I think there's epidermotropism with two types of cells seen in the epidermis- lymphocytes and monocytes with elongated nuclei. Would like to rule out Pagetoid reticulosis.

Agree with LSA, inflammatory phase. In this phase scattered lymphocytes are found at the dermal-epidermal interface and above it, however they don’t form clusters. No atypical lymphocytes and the intraepidermal ones show the same size of intradermal

LS, it can mimic MF

Agree with Mona.

Lichen sclerosus histologically mimetizing MF.

Perfect. I also thought LS. I would leave an unusual lichen planus and lichenoid contact dermatitis in the differential. Also agree that MF is not favored; the clinical also did not fit for MF. LS and LP are both known to be positive for clonality assays so those should be used with caution.

Thanks Uma.

Nice.