Melanocytic Proliferations Associated With Lichen Sclerosus

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Abstract
MELANOCYTES overlying scars exhibit an activated, regenerative phenotype manifested by HMB-45 expression and increased proliferation.1-3 In consequence, scars can exhibit clinical pigmentation or melanocytic hyperplasia.4,5 When the scar pigmentation is secondary to a persistent ("recurrent") melanocytic nevus, the histologic findings can be striking and mimic those of malignant melanoma, thus the moniker "pseudomelanoma."6-9 Keratinocytes overlying the dermal sclerosis in lesions of lichen sclerosus (LS) also manifest a regenerative phenotype.10 However, clinical pigmentation in LS is infrequent11 and melanocytic proliferations in LS are rare11-13 and difficult to interpret.14 In this study, we collected cases of melanocytic proliferations occurring in lesions of LS to determine their clinical pathologic characteristics and natural course. To more closely delineate the pathologic changes, we compared these LS-associated melanocytic lesions with ordinary compound (nondysplastic) melanocytic nevi, persistent melanocytic nevi, and persistent malignant melanoma.

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