Lichen Sclerosus-Like Changes in Acrochordons: A Case Series

Lichen sclerosus (LS) is a chronic inflammatory skin disease typically affecting anogenital regions, with occasional extragenital involvement; however, its occurrence in acrochordons is seldom reported. We present eight cases of LS-like changes within acrochordons in patients with no prior history of LS elsewhere. Histopathologic examination confirmed characteristic LS features localized to the acrochordons. These findings raise questions about whether such changes represent a localized response to friction and/or chronic intermittent pressure-type trauma or a form of primary extragenital LS. Current literature suggests trauma as a key pathogenic mechanism in both classic LS and its manifestation within acrochordons, and our cases further support this hypothesis. Notably, neither our patients nor previously reported cases had documented LS at other sites, suggesting that LS-like changes in acrochordons may represent an incidental histopathologic finding that should not necessarily raise concern for the development of LS elsewhere.