Lichen sclerosis Flashcards
What is lichen sclerosis
Chronic AI inflammatory skin condition presents with partches shiny porcelain white skin affecting labia, perineum and perianal skin, can affect axilla and thighs
Men - foreskin and glans penisAI
What causes lichen sclerosus and what conditions is it ass with
Autoimmune condition
Ass with T1DM, alopecia, hypothyroidism, vitiligo
Diagnosis of lichen sclerosus
History and exam, vulval biopsy can confirm
What is lichen simplex
Chronic inflammation and irritation caused by repeated scratching and rubbing of an area of skin
Different lichens and presentation
Lichen simplex - Presents with excoriations, plaques, scaling and thickened skin
Lichen planus - AI condition localised chronic inflammation, shiny, purplish, flat topped raised areas with wthie lines across surface wickhams striae
Lichen sclerosus - shiny porcelain white skin
What is wichams striae
White lines on top of purple areas in lichen planus
What person is typically affected by lichen sclerosus
women 45-60 years
Main symptoms lichen sclerosus
Vulval itching and skin changes #
Symptoms of lichen sclerosus
Itching
Soreness and pain - worse at nigth
Skin tightness
Painful sex - superfufucal dyspareunia
Erosions
Fissures
What is the koebner phenomenon
Signs and symptoms are made worse by friction to skin
What is the koebner phenomenon worsened by
Worsened by tight underwear that rubs the skin, urinary incontinence and scratching
How often is lichen sclerosis followed up
Every 3-6 months
Treatment for lichen sclerosis
Can’t cure, treat symptoms
Potent topical steroids - clobetasol propionate 0.05% - dermovate
Emollients
How do steroids help treat lichen sclerosis
Symptoms
Reduce risk of maliganancy
How often are topical steroids used in lichen sclerosis
once a day for four weeks
Reduced every four weeks to alternate days then twice weekly
Falre ups - daily until good control
30g tube should last at least 3 months
