Lichen Sclerosus

Lichen sclerosus is a long-term skin issue. It generally persists for years, and can cause permanent scarring. There is no known cure, though most people are considerably improved and quite comfortable with treatment. Early in the disease, small white spots appear on the skin. The spots are gradually shiny and smooth. Later, the spots grow into bigger patches. The skin on the patches becomes thin and crinkled. Lichen sclerosus is related with an increased risk of vulvar cancer, that presents as a slowly-growing lump or a sore that doesn't heal. It may strike up to 5% of patients with vulvar lichen sclerosus.

Anyone can get lichen sclerosus, but postmenopausal women and prepubertal children are at highest risk. Left untreated, lichen sclerosus may enhance your risk of skin cancer and lead to other complications. Similar effects occur around the anus. This makes normal bowel opening comfortless, often resulting in small tears which can be exceptionally sore. These damaged areas are often accompanied by blisters and sores which are susceptible to the further complications of infection and thrush. The cause of LS is not clear; healthcare providers equivocal that a number of factors may be involved.

In women, lichen sclerosus generally involves the vulva. In boys and men, uncircumcised males are most at risk, as the condition usually affects the foreskin. In children, the marks and symptoms may improve at puberty. Since lichen sclerosus affects such a sensitive area of the body it's essential to point out that it's not infectious, not sexually transmitted, and nothing to do with poor hygiene. Other autoimmune conditions such as thyroid disease, pernicious anaemia, vitiligo and alopecia areata are reported to be more typical than supposed in patients who have lichen sclerosus and in their families.

The diagnosis of lichen sclerosus can frequently be made from the typical appearance of the spots. However lichen sclerosus can apeear a bit like vitiligo (although this has a normal skin texture) and lichen planus (which is more purple). Strong topical steroid creams or ointments (especially clobetasol propionate) are very helpful for lichen sclerosus, specially when it strkies genital areas. They should be applied very exactly to the affected areas for a few weeks or months. Some patients find it helpful to apply an emollient cream or petrolatum different times a day to relieve dryness or itching.

Causes of Lichen sclerosus

The cause of lichen sclerosus is not fully understood and may involve genetic, hormonal and infectious components. Lichen sclerosus is supposed to relate to an autoimmune process, in which there are antibodies to a component of the skin. Though lichen sclerosus may involve skin around your genitals, it isn't infectious and cannot spread through sexual intercourse. In boys and men, uncircumcised males are most at risk, because the condition generally affects the foreskin. In children, the hallmarks and symptoms may improve at puberty.

Common causes and risk factors of Lichen sclerosus:

Hormone problems.
Previous skin damage at a particular site on your skin.
An overactive immune system.
Family history of lichen sclerosus.
Infectious components.

Signs and Symptoms of Lichen sclerosus

Early in the disease, small white spots appear on the skin. The spots are usually shiny and smooth. Later, the spots grow into larger patches. The skin on the patches becomes thin and crinkled. Discomfort is often greater if lichen sclerosus appears on or around your genital or anal areas. In the genital area, the scar-like process can tighten the skin, and this can interlope with sexual intercourse in affected men or women. In men, lichen sclerosus can make the foreskin tight and difficult to retract, and can even partly block the flow of urine.

Sign and symptoms may include the following :

Scar tissue covering the labia or clitoris.
Tenderness of the affected areas of your skin.
Easy bruising or tearing.
Flattened or absent inner lips of the vulva.
Ulcerated lesions.
Narrow opening of the vagina.

Treatment for Lichen sclerosus

Lichen sclerosus of the genital skin should be cured. Treatment also involves using very strong cortisone cream or ointment on the skin. You put these creams on the patches every day for many weeks. Antibiotics are required when infection is present and anti-fungal treatments are required for thrush. Although lichen sclerosus is said to resolve spontaneously after a number of years, it tends to cause physical damage in the meantime. This damage often requires repairing with surgical operations.

Treatment may include:

The use of ultrapotent topical corticosteroid creams and ointments are very suitable for the treatment of lichen sclerosus.
The circumcision is the most widely used therapy for lichen sclerosus. This procedure removes the affected skin, and the disease usually does not recur.
The new immune modulating creams tacrolimus and pimecrolimus look promising for treating lichen sclerosus.
Birth control pills often thin vulvar skin and worsen symptoms overall.
Other treatments include calcipotriol cream , topical and systemic retinoids (acitretin).

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