Köbnerization in a woman with generalized lichen sclerosus

A 52-year-old woman presented with an 18-month history of genital and extragenital lichen sclerosus. In addition to the classical genital findings, lesions of lichen sclerosus were present over her back, chest and the medial aspect of her right thigh and leg. On her right thigh and extending to her right leg, lesions of lichen sclerosus displaying the Köbner response were noted over the course of a varicosed long saphenous vein. There were no features of varicose dermatitis in the region displaying the Köbner response. It is proposed that the ambulatory venous pressure within the vein acted as a stimulus for the Köbner response.