Describe the clinical signs of lichen sclerosus of the vulva.

The characteristic findings associated with lichen sclerosus include white, thinned, crinkled skin (it is frequently described as “cigarette paper” atrophy). Often there are areas of ecchymoses in the involved skin. The majority of the vagina is usually unaffected; however, a patient may have involvement of the vaginal introitus, leading to stenosis. One also may find fusion of the labia minora, phimosis of the clitoral hood, and fissures. LS can also simultaneously involve the perianal area, which then forms a “figure-of-eight” pattern.

Val I, Almeida G: An overview of lichen sclerosus, Clin Obstet Gynecol 48(4):808–817, 2005.