Lichen sclerosis et atrophicus is characterized by the development of well demarcated, depigmented macules with epidermal atrophy. Hemorrhage occurs occasionally; however, telangiectasia is seldom remarkable. We studied a case of lichen sclerosis et atrophicus with striking telangiectasia which involved a 62-year-old male who was suffering from this disorder on his upper back. An initial lesion had been excised 15 years earlier. Thirteen years after the original surgery, he noticed a similar skin eruption accompanied by telangiectasia that had recurred around the surgical scar. We present here a detailed description of this case and provide a short review of the literature.