Elastophagocytosis in extragenital lichen sclerosus.
BACKGROUND
Elastophagocytosis, or elastic fiber phagocytosis by multinucleate macrophages, has been observed in different skin conditions that may or may not occur on sun-exposed skin. Although loss of elastic fibers has been well documented in the homogenized papillary dermal zone in lichen sclerosus (LS), elastophagocytosis, to the best of our knowledge, has never been observed.


METHODS
We encountered striking elastophagocytosis in a case of extragenital LS which prompted us to review all cases of LS diagnosed at the Skin Pathology Laboratory at Boston University over a 2-year period to assess for the presence of elastophagocytosis.


RESULTS
In 7 of 35 patients diagnosed with LS (20%), we found prominent elastophagocytosis to be present either immediately below or at the junction of the homogenized collagen and the normal underlying reticular dermis. Interestingly, all the cases in which elastophagocytosis was observed were in extragenital locations.


CONCLUSIONS
Elastophagocytosis was observed in 20% of LS cases, all of which were extragenital. We hypothesize that elastophagocytosis in LS, especially in extragenital sites, may not be an epiphenomenon but rather represents a contributing factor to elastic fiber loss in the hyalinized papillary dermal collagen that typifies this disease.
Abbas
Ossama
O
Section of Dermatopathology, Department of Dermatology, Boston University School of Medicine, Boston, MA, USA.
Chatrath
Vandana
V
Goldberg
Lynne J
LJ
D000368:Aged; D000369:Aged, 80 and over; D004547:Elastic Tissue / Q000473:pathology*; D005260:Female; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010587:Phagocytosis