Although in the past lichen sclerosus et atrophicus (LSA) has been considered to be related to several other dermatoses,10 most authors6,9,27,34,36 now accept the opinion of Kyrle14 that it is a separate entity. Nevertheless, the description of the histologic structure of LSA found in textbooks is far from uniform. For example, according to Lever16 a pronounced edema is found in the upper corium, but Allen1 describes the change in this region as a dense zone of homogenized collagen. Gans and Steigleder7 point out that in LSA the upper portion of the corium may appear homogeneous and be both sclerotic and edematous. All investigators agree that the elastic fibers are reduced or absent in the corium involved by LSA. Lutz18 and Miescher19,20 feel that the fibers are destroyed. Montgomery and Hill,22 however, state that they are not actually destroyed, but pushed aside