History: This lady has had lichen sclerosus for 4 years.The initial lesions are flat white topped papules which join up to form plaques.The lesions may coalesce into large atrophic patches and plaques leaving wrinkled skin.Occasionally areas of damage at the basal layer of the epidermis are extreme and blistering can occur with hemorrhage and crusting.This lady had no vulval involvement which was unusual in this condition.