Lichen sclerosus of the eyelid involving the eyelash margin

Abstract

Lichen sclerosus is a debilitating and chronic disease that typically affects the anogenital area, although it can also be found on extragenital locations such as the shoulders, neck, trunk, breasts, and arms. Facial involvement is rare, but there have been a few reported cases of extragenital lichen sclerosus affecting the infraorbital area. To our knowledge, there are 7 documented cases of extragenital lichen sclerosus affecting the eyelid in medical literature. This is a novel case and documented report of a patient with extragenital lichen sclerosus located on the eyelid with eyelash margin involvement.

FIGURE 1

(a) Initial Ophthalmic examination. Flat, hypopigmented patch (32 × 20 mm) with scalloped borders involving the left lower eyelid and medial eyelash margin presenting in a 46‐year‐old patient. (b) Following initial punch biopsies, the left lower eyelid area remains without evidence of skin thickening, induration, or ulceration.

FIGURE 2

Initial biopsy. There is compact orthokeratosis and thinning of the epidermis. A broad zone of eosinophilic homogenized collagen is present in the superficial dermis with an underlying lymphoplasmacytic infiltrate.