Studies of 82 skin specimens from 81 cases of lichen sclerosus et atrophicus (LSA) are reported. Typical LSA pathological changes showed atrophy of the epidermis, hydropic degeneration at the basal layer, and homogenization of the collagen fibers in the superficial dermis with inflammatory cell infiltration underneath. Ultrastructural changes showed intercellular spaces enlarged, particularly near basal cells. Some mitochondria were swollen and rough endoplasmic reticula were enlarged. Some basement membranes were thinner, collagen fibers of varying diameters were arranged in irregular shapes and the fine structures had become unclear and had sometimes even disappeared.
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