Hypopigmented plaque with cut dragon fruit appearance

A 32-year-old male presented with a whitish, hypopigmented asymptomatic skin lesion over his upper back for six months, with no similar lesions reported elsewhere.On examination, a 5 5 cm hypopigmented atrophic plaque, with follicular plugging and peripheral hyperpigmentation was observed on the right upper back, resembling the appearance of a cut dragon fruit [Figure 1].Dermoscopy revealed structureless areas, comedo-like openings, white chrysalis-like structures, and telangiectasia.Histopathology showed follicular plugging, epidermal thinning, loss of rete ridges, focal basal cell vacuolization, and edema and hyalinization of the papillary dermis [Figure 2].After correlating clinical findings, dermoscopic results, and histopathological features, the diagnosis of extragenital lichen sclerosus et atrophicus (LSA) was made.