lichen sclerosis

  • Pt: postmenopausal women
  • cause: autoimmune, atrophy etiology. Benign lesion characterized by a thinning of the epidermis and fibrosis (sclerosis) of the underlying dermis.
  • 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).
  • dx: Punch biopsy of adult-onset lesions to exclude malignancy
  • rx: high potency topical steroids
  • complications: Lichen Sclerosis is associated with a slightly increased risk of squamous cell carcinoma.

Lichen sclerosisLichen simplex chronicus
skin thinningskin thickening
autoimmune, atrophychronic irritation
risk of sccno risk