Lichen Sclerosus – Causes, Symptoms & Treatment

by andywalsh | March 27, 2019 1:14 am

Lichen sclerosus is a chronic inflammatory skin disorder that can affect men, women, or children, but is most common in women. It usually affects the vulva (the outer genitalia or organ) and the anal area. Sometimes, lichen sclerosus appears on the upper body, breasts, and upper arms. It can start at any age, although it is most often seen in women over 50. Prepubertal girls can also be affected. It may cause no symptoms but it can be itchy, sometimes severely so. It can develop after an injury to the affected area. It may follow or co-exist with another skin condition such as lichen simplex, candidiasis or erosive lichen planus.

Diagnosis can usually be based on appearance, especially in advanced cases; however, biopsy should be performed on any anogenital dermatosis that does not resolve with mild conventional therapy (eg, topical hydrocortisone or antifungal). It is especially important to biopsy any area that becomes thickened or ulcerated, as lichen sclerosus is a precursor of squamous cell carcinoma. Treatment consists of potent topical corticosteroids. The disease is generally intractable, so long-term followup, especially to monitor for squamous cell carcinoma and function and for psychologic support, is indicated.

Lichen striatus is a rash that consists of small raised bumps. Lichen sclerosus et atrophicus is a chronic skin disease characterized by white, flat papules with an erythematous halo and black, hard follicular plugs. In advanced cases, the papules tend to coalesce (blend) into large, white patches of thin, itchy skin. Lesions often occur on the torso and, almost invariably, in the anogenital (relating to both the anal and the genital) regions. The symptoms are the same in children and adults.

Early in the disease, small, subtle white spots appear. These areas are usually slightly shiny and smooth. As time goes on, the spots develop into bigger patches, and the skin surface becomes thinned and crinkled. As a result, the skin tears easily, and bright red or purple discoloration from bleeding inside the skin is common. More severe cases of lichen sclerosus produce scarring that may cause the inner lips of the vulva to shrink and disappear. Lichen sclerosus occurs almost exclusively in uncircumcised men. Skin on other areas of the body affected by lichen sclerosus usually does not develop scarring.

Causes of Lichen Sclerosus

Find common causes and risk factors of Lichen Sclerosus:

Signs and Symptoms of Lichen Sclerosus

Sign and symptoms may include the following:

Treatment for Lichen Sclerosus

Treatment may include:

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