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Histopathological differences between vitiligo and lichen sclerosus et atrophicus using quantitative
Young Joon Park1, Heera Lee2, Hyoung Soo Park1
1Department of Dermatology, Ajou University School of Medicine, Suwon, Republic of Korea.
Frontiers in Medicine
|July 31, 2023
Summary
Lichen sclerosus et atrophicus (LS) often shows more melanin and melanocytes than vitiligo, but some LS cases have less, requiring careful clinical and histological differentiation.
Area of Science:
- Dermatology
- Histopathology
- Immunohistochemistry
Background:
- Lichen sclerosus et atrophicus (LS) presents as whitish patches, primarily in genital/perianal areas, and can cause depigmentation.
- Differentiating LS from vitiligo based on hypopigmentation is challenging due to limited comparative histopathological data.
Purpose of the Study:
- To quantitatively compare the pigmentary characteristics of LS and vitiligo lesions.
- To investigate histochemical and immunohistochemical differences in melanocyte and melanin content between LS and vitiligo.
Main Methods:
- Retrospective review of 31 LS and 46 vitiligo patient biopsy specimens.
- Analysis using Fontana-Masson staining for melanin and immunohistochemistry for Melan-A, NKI/beteb, tyrosinase, and MITF.
Main Results:
- LS epidermis generally exhibited higher melanin content and melanocyte counts than vitiligo.
- A subset of LS specimens (22.6%-29.0%) showed reduced melanin, fewer melanocytes, or lower melanocyte activity compared to vitiligo.
- Significant overlap in pigmentary features was observed between the two conditions.
Conclusions:
- While LS typically has higher pigmentation, some cases mimic vitiligo's hypopigmentation.
- Comprehensive clinical and histological evaluation is crucial for distinguishing LS from vitiligo.
