We report a 13-year-old female child with sequentially occurring lesions of extragenital zosteriform lichen sclerosus et atrophicus (LSA). The skin lesions first appeared at the right waist when she was 8 years and gradually extended inferiorly and medially along the dermatome of the right L1-2. Subsequently, another skin lesion occurred along the dermatome of the left L5-S1 from the left buttock to left dorsum of the foot in the following 5 years. Microscopic findings obtained from the right inguinal sclerotic plaque revealed typical features of LSA. We report the first case of bilateral zosteriform LSA and remind clinicians of including lichen sclerosus in the differential diagnoses of cutaneous zosteriform lesions.