One hundred and seven patients with lichen sclerosus et atrophicus (LSamp;A) of the vulva were studied to determine the malignant potential of the LSamp;A. Five patients had coexisting invasive carcinoma of the vulva or perineum with the LSamp;A, and 1 patient had coexisting intraepithelial vulvar carcinoma on the clitoris. None of these, however, was known to have LSsol;A prior to the biopsy for carcinoma of the vulva. The high association of carcinoma and LSamp;A is probably a result of selection of 2 unusual lesions sent for consultation and evaluation. Squamous hyperplasia in the vulva occurred in association with LSamp;A in 37 (35percnt;) patients, but only G patients had areas of dysplasia coexisting with LSamp;A. These areas of dysplasia, like the 5 invasive carcinomas, occurred in an area of the vulva where the LSamp;A was minimal or absent. Follow-up data were obtained on 92 patients with LSamp;A. Only 1 developed carcinoma of the vulva, which occurred 12 years after identification of the LSamp;A. When carcinoma arises in the vulva in a patient with vulvar LSamp;A, it tends to arise in areas of minimal LSamp;A or isolated areas of relatively normal vulvar skin. This study did not provide evidence of carcinoma arising from LSamp;A. Five of the 92 patients developed 6 malignant neoplasms in other sites, including carcinoma of the endometrium (3 patients), lung (1 patient), and simultaneous carcinomas of the colon and cervix
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