Gynae Dermatology

Question 1

What is Lichen Sclerosus?

Answer 1

Chronic inflammatory skin condition, usually affecting genital skin (vulva) and perineum

• Not contagious
• Occurs at extremes of age: <10yo, >60yo

Question 2

What is the aetiology of lichen sclerosus?

Answer 2

• Autoimmune
  
  • Hypothyroidism
  • Graves’ Disease
  • T1DM
• Genetic

Question 3

What are the signs and symptoms of lichen sclerosus?

Answer 3

• “White, polygonal papules”
  
  • Hypopigmentation + atrophy
• Pruritis
• White/shiny vulva (“Figure of 8 pattern”)
  
  • May be raised or thickened
• Dyspareunia (due to tightened skin)
• Dysuria (due to tightened skin)
• Can be on wrists, upper trunks, around breasts, neck, armpits

Question 4

What are the appropriate investigations for lichen sclerosus?

Answer 4

Clinical diagnosis

Question 5

What is the management of lichen sclerosus?

Answer 5

• Good skin care
• 1st line (3 months) = clobetasol propionate (strong steroid ointments)
• 2nd line = tacrolimus (topical calcineurin inhibitor) + biopsy (as steroid-resistant)

Question 6

What are the complications of lichen sclerosus?

Answer 6

• Never can be completely cured
• Squamous cell cancer