A 76-year-old woman presented with a 7-mm, hard, pink nodule at the site of
an appendectomy scar of more than 70 years' duration. The clinical impress
ion at the time of biopsy was that of a keloid. Surprisingly, light microsc
opic examination revealed classic histologic features of late-stage lichen
sclerosus et atrophicus (LSA) overlying a scar. Elastic tissue stain highli
ghted the unusual presence of abundant nodules of elastin in the reticular
dermis only.