Many think that this condition is related to morphoea, with which it may coexist. However, its patches are non-indurated white shiny macules, sometimes with obvious plugging in the follicular openings. Women are affected far more often than men and, although any area of skin can be involved, the classical ivory-coloured lesions often surround the vulva and anus. Intractable itching is common in these areas and the development of vulval carcinoma is a risk. In men the condition may cause stenosis of the urethral meatus, and adhesions between the foreskin and glans of the penis.