Question: Can you identify this condition?

A 55-year-old woman presents with a longstanding history of multiple ivory-white atrophic patches involving the vulvar and perianal area that appear in a “figure-eight” (bidirectional) pattern. Superficial telangiectases are present. The involved areas are pruritic and the patient complains of dysuria, dyspareunia, and pain with defecation. In addition, the patient has several ivory-white papules coalescing into atrophic plaques on her upper back.

The most likely diagnosis is

1. Lichen planus

2. Scleroderma

3. Vitiligo

4. Discoid lupus erythematosus

5. Lichen sclerosus

Answer on page 713

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