Long-standing vulvar lichen sclerosus in a 55-year-old woman with severe pruritus for eight years. She woke up most nights scratching. Clitoris is almost buried. The inner labia minora and vulvar trigone are thick, firm, and white with two biopsy sites visible on the left side.
Reproduced with permission from: F William Danby, MD, FRCPC, FAAD, and Lynne J Margesson, MD.