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