Histochemical differentiation of localized morphea-scleroderma and lichen sclerosus et atrophicus

Dermatologic literature has debated the occurrence of concomitant morphea-scleroderma (M-S) and lichen sclerosus et atrophicus (LSA) for sometime. Presentation of a case which has the appearance of both M-S and LSA creates a diagnostic dilemma frequently unresolved even by histopathology. Routine hematoxylin and eosin stained sections may add to the confusion and the difficulty of the differentiation, but examination for the presence or absence of elastic fibers in the upper corium of the lesions affords a definitive separation of these two conditions.