No specific gene expression association observedGene expression interpreted as non-specific inflammatory tissue responseOnly 7% of patients (n = 23) in a case series had associated autoimmune conditions(alopecia areata, vitiligo, thyroid disease and ulcerative colitis)11Fewer patients with male lichen sclerosus (LS) had antinuclear antibodies or autoimmunediseases than general population15,16Autoantibodies to extracellular matrix protein 1 have been observed but may be anepiphenomenon4. The gene discussed is ECM1; the disease is Leigh syndrome.