Lichen Sclerosus - Symptoms and Treatment

Lichen sclerosus is a chronic inflammatory skin disorder that results in white atrophic papules that may contain a central depression or a black keratotic plug. In advanced cases, the papules tend to blend into large, white patches of thin, itchy skin. Lichen sclerosus also called Hallopeau's disease. The lesion often occur on the torso and in the anogenital regions. In the latter case, the disease is called kraurosis vulvae. It is a skin disorder that can affect men, women, or children, but is most common in women. It usually occurs on the vulva (the outer genitalia organ) in women. Occasionally, lichen sclerosus is seen on other parts of the body, especially the upper body, breasts, and upper arms. 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, the clitoris to become covered with scar tissue, and the opening of the to narrow. Lichen sclerosus occurs almost exclusively in uncircumcised men (those who have not had the foreskin removed). The foreskin can scar, tighten. Skin on other areas of the body affected by lichen sclerosus usually does not experience scarring.

Lichen sclerosus is a painful skin condition that typically affects the vulva and anus. Anyone can get lichen sclerosus, but postmenopausal women and prepubertal children are at highest risk. Left untreated, lichen sclerosus may increase your risk of skin cancer and lead to other complications. Treatment of lichen sclerosus may involve medications. It can occur at any age but most commonly develops in middle aged women. It is estimated that lichen sclerosus affects about 1 in 1000 women, but it may be more common than this as some mild cases may go undiagnosed. In males, lichen sclerosus affects the foreskin. It is uncommon but can occur at any age, including young boys. Lichen sclerosus in males used to be called balanitis xerotica obliterans. The cause of lichen sclerosus is unknown. On some occasions it is associated with the kind of diseases which involve the production of antibodies against the body's own tissue, e.g. thyroid disease or diabetes. However, there is no evidence that this process is involved in lichen sclerosus itself. It is quite certain that the disease is not contagious, so the partner cannot contract. Pregnancy and delivery are not made more difficult.

Causes of Lichen Sclerosus

Common Causes of Lichen Sclerosus :

• To some extant, the family history of lichen sclerosus is responsible of it.
• The main cause may be an overactive immune system .
• The other causes may include genetic , hormonal and infectious components.
• The thyroid disease , pernicious anaemia, vitiligo and alopecia areata can lead to the condition of lichen sclerosus.

Symptoms of Lichen Sclerosus

Some common Symptoms of Lichen Sclerosus :

• Bleeding.
• White spots.
• Itching.
• Blisters.
• Crinkled skin.
• Tenderness of the affected areas of your skin.
• Easy bruising or tearing.

Treatment of Lichen Sclerosus

• The use of ultrapotent topical corticosteroid creams and ointments are very suitable for the treatment of lichen sclerosus.
• Other treatments include calcipotriol cream , topical and systemic retinoids (acitretin).
• Avoid any soap on your vulva and wash no more than once a day with clear water only using your fingers instead of a wash cloth. 
• Do not use any douches, perfumes, feminine hygiene sprays, commercial lubricants, or other substances on the vulva other than those prescribed or suggested.
• The circumcision is the most widely used therapy for lichen sclerosus. This procedure removes the affected skin, and the disease usually does not recur.

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