Extensive isolated extragenital hemorrhagic bullous lichen sclerosus in a 75-year-old Yemeni woman: A case report

term ''lichen sclerosus" was adopted. 2 The bullous clinical variant of LS, caused by the hydropic degeneration of basal keratinocytes, is rare.The hemorrhagic bullous variant is even rarer. 1While LS affects both sexes and all age groups, its incidence is higher in women than in men (10:1), especially among those aged 50-60 years. 2 The anogenital area is predominantly involved, with an extragenital-to-anogenital lesion ratio of 1:5. 3 Exclusive extragenital LS (EGLS) without genital lesions is extremely rare, whereas EGLS with concomitant genital involvement is common.Both can be classified as localized or disseminated depending on the surface area.Only 45 cases of EGLS with bullous lesions (EGBLS) have been reported, comprising 32 and 13 cases of exclusive EGBLS and EGBLS with concomitant genital lesions (Table 1), respectively.The 32 EGBLS-only cases comprise 10 and 22 cases of hemorrhagic and non-hemorrhagic bullae, respectively.Only two exclusive EGBLS cases with disseminated hemorrhagic lesions have been reported; this report describes the third case to date. 1 Clinically, extragenital lesions present as whitish papules and plaques with wrinkled surfaces and superficial horny plugs. 4They are seldom pruritic but are usually asymptomatic.Herein, we report a case of extensively isolated extragenital bullous and hemorrhagic LS, an atypical and extremely rare variant of the disease.