Introduction

Lichen sclerosis is an idiopathic inflammatory disease first described by Hallopeau in 1887 [1]. The etiology of lichen sclerosis is a mystery, with evidence suggestive of autoimmune activity with association with HLA class II antigens and comorbidity with autoimmune diseases, especially thyroid disease, in patients with genetic background.

It is a disease that most commonly affects the anogenital area with extragenital disease in 15-20% of patients [2-4]. Extragenital disease is characterized clinically by white, polygonal papules that coalesce into plaques, located on the neck and shoulders and are usually asymptomatic [2]. The rate of isolated extragenital lichen sclerosis (ELS) is 2.5% [4].

Case Report

A 25-year-old male, skin type 5, presents to the outpatient dermatology clinic with a complaint of asymptomatic hypopigmentation along the hairlines for three weeks only. Not proceeded by itching or burning. The clinical examination showed a well-demarcated hypopigmented linear patch on the border of the frontal hairline with a solitary polygonal porcline white macule (Figures 1 and 2). Oral and genital mucosae were normal. Wood’s light examination showed no accentuation.

Figure 1: Well demarcated linear hypopigmented patch along the left frontal hairline.

Figure 2: Well-demarcated linear hypopigmented patch along the right frontal hairline.

Dermoscopy

Showed structureless whitish, homogenous areas, with erythematous halo and peripilar white halo. (Figures 3 and 4).