Lichen sclerosus (LS) is a chronic inflammatory dermatosis causing atrophy and scarring that may involve both genital and extragenital areas. LS initially presents with small, pink to ivory-white polygonal papules that coalesce into porcelain-white plaques, determining atrophy and scarring. The main dermatoscopic features of genital LS are the presence of whitish to yellow-whitish patches or papules, associated with white shiny lines and linear branching or dotted vessels. Minor findings include structureless pinkish or brownish background, erosions, peppering, hemorrhages, gray-blue dots with a characteristic arrangement, scales, and comedo-like openings. Dermatoscopy is a helpful tool also for the diagnosis of extragenital LS, revealing a homogeneous whitish area surrounded by an erythematous or hyperchromic halo which encompass differential diagnosis with vitiligo. Multiple roundish to oval yellow circles (comedo-like openings) can be noticed on the whitish background, especially in early lesions.