Lichen sclerosus (LS) is a chronic disorder with a predilection for the anogenital area. In this anatomic area, a subset of human papillomavirusenegative neoplasms arise on the background of chronic inflammation, of which LS is the most common condition.
Of these neoplastic associations, squamous intraepithelial neoplasias, including the differentiated (simplex) type of vulvar intraepithelial neoplasia and penile intraepithelial neoplasia (PeIN), are salient lesions.1 A rare and unusual feature in LS is a conspicuous accumulation of elastic fibers in the level of the mid to lower part of the reticular dermis, sometimes strikingly apparent on hematoxylin-eosinestained slides.