lichen sclerosis
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related: OBGYN, lichen simplex
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Pt: postmenopausal women
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cause: autoimmune, atrophy etiology. Benign lesion characterized by a thinning of the epidermis and fibrosis (sclerosis) of the underlying dermis.
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sx:
- early stage: hypopigmented areas, increase sensitivity = intense itching with erosions/excoriations
- chronic stage: scratching/irritation causes thickened skin (lichenification) and vulvar plaque
- severe stage: structural changes, loss of labia minoria, clitoral hood = obstruct urethra causing dysuria, incomplete voiding, nocturia
- The lesions of lichen sclerosis commonly present as a white patch (leukoplakia) with “parchment-like” vulvar skin (like paper).
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dx: Punch biopsy of adult-onset lesions to exclude malignancy
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rx: high potency topical steroids
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complications: Lichen Sclerosis is associated with a slightly increased risk of squamous cell carcinoma.
Lichen sclerosis | Lichen simplex chronicus |
---|---|
skin thinning | skin thickening |
autoimmune, atrophy | chronic irritation |
risk of scc | no risk |