title: Coexistence of lichen sclerosus and morphea: a retrospective analysis of 472 patients with localized scleroderma from a German tertiary referral center.
abstract: BACKGROUND
  The coexistence of lichen sclerosus (LiS) and localized scleroderma (LoS) has sporadically been reported in the literature. Recently, a prospective multicenter study demonstrated a surprisingly high percentage of genital LiS in patients with morphea.
  
  
  OBJECTIVE
  The aim of this study was to determine the prevalence of LiS in a cohort of patients with LoS who presented at a tertiary referral medical center for connective tissue diseases in Germany.
  
  
  METHODS
  We retrospectively evaluated the prevalence of genital and extragenital LiS in adult and pediatric patients with different subtypes of LoS. Secondary outcome measures included demographic characteristics and prevalence of other concomitant autoimmune diseases.
  
  
  RESULTS
  Of the 472 patients (381 adults, 91 children; mean age: 46 years; range, 4-88 years; female to male ratio: 3.5:1 in adults and 8:1 in children) with LoS, 27 (5.7%) also presented with LiS (19 extragenital and 8 genital lesions). LiS exclusively occurred in patients with plaque-type (morphea) and generalized LoS. Twenty-six of the 27 (96.2%) patients with concomitant LoS and LiS were adults. Compared with LiS in the general population, LiS was significantly more frequent in LoS as indicated by an odds ratio of 18.1 (95% confidence interval 2.6-134.2; P < .0001). In all, 38 (8.1%) patients with LoS had other autoimmune disorders (most frequently Hashimoto thyroiditis, rheumatoid arthritis, and alopecia areata).
  
  
  CONCLUSIONS
  This was a retrospective study.
  
  
  CONCLUSIONS
  This large retrospective analysis confirms recent reports of a high prevalence of LiS in patients with LoS. Based on these findings, patients with LoS, especially those with morphea, should be carefully screened for concomitant LiS, including inspection of the anogenital region.
authors.affiliation: Connective Tissue Disease Research Unit of Department of Dermatology, Venereology, and Allergology, Ruhr University Bochum, Bochum, Germany. a.kreuter@derma.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Kreuter
authors.forename: Jana
authors.initials: J
authors.lastname: Wischnewski
authors.forename: Sarah
authors.initials: S
authors.lastname: Terras
authors.forename: Peter
authors.initials: P
authors.lastname: Altmeyer
authors.forename: Markus
authors.initials: M
authors.lastname: Stücker
authors.forename: Thilo
authors.initials: T
authors.lastname: Gambichler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012594:Scleroderma, Localized / Q000150:complications*; D062606:Tertiary Care Centers; D055815:Young Adult