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We here report a case of a middle‐aged man with an unusual case of bullous lichen sclerosus complicated with generalized morphea. He showed initial recurrent flaccid bullae, followed by ivory‐white sclerotic plaques and extensive skin sclerosis, with additional walking disorder caused by knee‐joint contracture, and ulcers on the lower extremities and back. The patient had no visceral involvement. After oral hydroxychloroquine and oral corticosteroids failed, the patient was given tofacitinib, which resolved his ulcers after 4 weeks and ameliorated his knee‐joint contracture and skin sclerosis within 4 months. Owing to the occurrence of diffuse large B‐cell lymphoma, he stopped using tofacitinib, and the ulcer and walking disorder reappeared. This is rare case of bullous lichen sclerosus–generalized morphea overlap syndrome. The patient recovered well after treatment with tofacitinib. His symptoms recurred after discontinuation of tofacitinib. [ABSTRACT FROM AUTHOR]

Internal malignancy may be presented in the form of paraneoplastic syndromes, which may indicate either formation or recurrence of a previously treated malignancy. Furthermore cutaneous paraneoplastic disorders often precede a diagnosis of cancer. We present 2 unique case reports with cutaneous paraneoplastic manifestations. The first one describes a patient with sudden progression of long-term stabilized morphea in connection with newly diagnosed hepatocellular carcinoma (HCC). The second one describes female patient with breast cancer preceded by the development of extragenital lichen sclerosus (LS) with typical sclerotic lesions and hemorrhagic bullae.

• Photodynamic therapy for lichen sclerosus results in significant curative effect and low recurrence rate. • Fire needling combined with photodynamic therapy can increase synergy and is a good adjunct. In this work, we treated a case of stubborn bullous lichen sclerosus with photodynamic therapy(PDT) combined with fire needle. After 3 sessions of PDT ,pretreated with fire needle, most of the patient's skin lesions subsided and symptoms improved significantly. We found that photodynamic therapy is a potential treatment modality for lichen sclerosus with significant efficacy. Combined with fire needle pretreatment, which may not only promote the transdermal absorption of the drug, but also play a synergistic effect. [ABSTRACT FROM AUTHOR]