Lichen Sclerosis

Last updated 20.09.12

Index

Definition

- Chronic skin disorder typically effecting genital & perianal area

Features

- Idiopathic

- May cause permanent scarring

- Women 10:1 men

- Can occur at any age

- More common prepubertal or >50yrs

Risk Factors

- AID: DM Type 1, hyper/hypothyroidism, alopecia areata, pernicious anaemia, vitliigo

- 30% 1st degree relative w AID

- Atopy 97%

- Women of non child bearing age

- Urinary or bowel incontinence

Associated S/S

- White thickened skin of vulva

- Never effects inside vagina

- Scarring

- Labial fusion

- Vaginal stenosis

- Pruritis

- Vulvodynia, dyspareunia

Complications

- Increased risk of vulval cancer (VIN) 5%

Ix

- Skin biopsy

- BSL: DM Type 1

- TFT: hyper/hypothyroidism

Mx

- Non-soap cleansers

- Oestrogen cream/ointment (if atrophic)

- Steroids: Clobetasol Daily

- Relapse common

- Referral

- Tacrolimus by specialist

- Surgery

- VIN/SCC

- Labial fusion & vaginal stenosis

References

DermNet NZ: Lichen Sclerosis, 11/08/2012