Lichen Flashcards
What is lichen sclerosus?
chronic inflammatory skin disorder
most often affects genital + perianal areas.
In which patients is lichen sclerosus most common?
> 50s/ post menopausal
Give 4 features of appearances of lichen sclerosus
White patches
Crinkled/ thickened
Ulcers/ blood blisters from itching
NEVER affects vaginal mucosa
Give 3 symptoms of lichen sclerosus
Extremely itchy + sore
Dyspareunia
Dysuria- stinging
What investigations are used for lichen sclerosus?
Clinical dx
Biopsy required if fail to respond to Tx or if clinical suspicion of VIN or cancer.
What is the management of lichen sclerosus?
Topical steroid ointment
Emollients
F/U due to increased risk of vulval SCC
Give one complication of lichen sclerosus
Vulval SCC
What is lichen planus?
chronic inflammatory condition affecting the skin + mucosal surfaces.
Give 3 features of appearances of lichen planus
Erosive, glazed or glossy erythematous POLYGONAL plaques
Bluish-purple, shiny, flat-topped papules with small white dots or lines (WICKHAM’s striae)
Uniformly white hyperkeratotic plaques.
Which sites can be involved in lichen planus?
Hands
Feet
Genitalia
Nails
Buccal mucosa
Which areas of the vulva may be affected by lichen planus?
labia majora
labia minora
vaginal introitus.
Describe vulval lichen planus
Painless white streaks in a lacy or fern-like pattern
Painful + persistent erosions + ulcers (erosive LP)
Scarring, resulting in adhesions, resorption of labia minora + introital stenosis
What is management for vulval lichen planus?
Potent topical steroids
Emollients
What is lichen simplex?
chronic itchy skin disorder characterised by well demarcated, erythematous patches, + plaques of thickened leathery skin.
In which groups is lichen simplex more common?
personal or FH of atopy, but can be the result of any factors causing repeated scratching or rubbing.
