[Diffuse lichen sclerosus et atrophicus involving the palms].

Lichen sclerosus et atrophicus (LSA) is an extremely rare condition which usually involves the genitalia. There are sporadic reports of diffuse LSA with hand involvement apparently the rarest. Although the clinical course of the disease is often benign, there may be widespread lesions, disabling joint contractures, and cutaneous malignancies. We report on a patient in whom diffuse LSA appeared in the sixth decade. The condition led to multiple aggressive squamous cell carcinoma in the upper limbs and other anatomic sites and severe deforming and disabling contractures of the fingers and palms which prevented the patient's use of his hands even for simple tasks. On the basis of our experience, we suggest the application of aggressive primary treatment for cutaneous lesions in LSA.