Lichen Sclerosus

Question 1

lichen sclerosus
-what?

Answer 1

Chronic autoimmune inflammatory condition which presents with porcelein white skin on the labia/ perineum/ perianal skin in women

Question 2

lichen sclerosus
-risks?

Answer 2

-other AI conditions

2 peaks= pre pubertal and postmenopausal

Question 3

lichen sclerosus
-symptoms?

Answer 3

Symptoms:
* Itching
* Soreness and pain
* Skin tightness
* Painful sex
* Erosions, fissures, cracks
* Porcelain white, shiny, tight, thin, slightly raised, may be papules or plaques

Koebner phenomenon= signs and symptoms made worse by friction

Question 4

lichen sclerosus
-appearance?

Answer 4

-Resorption of inner labia
-Narrowing of introitus
-Midline fusion at vestibule/posterior fourchette
-Pallor
-Erythema
-No ecchymoses, no hyperpigmentation
-No ulceration or fissures
-No nodules

Question 5

lichen sclerosus
-where found?

Answer 5

Common places:
-labia
-perineum
-perianal skin

Men= foreskin + glans of penis

Other:
-axilla
-thighs

Question 6

lichen sclerosus
-treatment?

Answer 6

Cant be cured

Genital skin care advice and emollient
-Try to avoid tight clothing and rubbing
-Avoid irritants

Super potent topical steroid = Clobetasol Propionate 0.05% (AKA Dermovate)
– half fingertip unit
-12 week regime
-30g tube should last 12 weeks

Question 7

complications- lichen sclerosus?

Answer 7

3-5% chance of developing into SCC