A 62-year-old postmenopausal woman presents with intense vulvar pruritus and white, atrophic plaques. Biopsy shows thinning of the epidermis, hyalinization of the superficial dermis, and a band-like lymphocytic infiltrate. What is the most likely diagnosis?
- A Lichen simplex chronicus
- B Vulvar intraepithelial neoplasia III
- C Lichen sclerosus ✓
- D Squamous cell hyperplasia
Correct answer: C. Lichen sclerosus
Explanation
The triad of epidermal thinning, superficial dermal hyalinization, and a band-like lymphocytic infiltrate is diagnostic of lichen sclerosus. Lichen simplex chronicus and squamous cell hyperplasia show hyperkeratosis and acanthosis without hyalinization. VIN III displays full-thickness dysplasia without the characteristic stromal changes. Lichen sclerosus carries a small risk of progression to squamous cell carcinoma.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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