Disease: Lichen Sclerosus

    *Lichen sclerosus facts

    *Lichen sclerosus facts author: John P. Cunha, DO, FACOEP

    • Lichen sclerosus is a long-term problem of the skin that mostly affects the genital and perianal areas.
    • Lichen sclerosus is most commonly seen in post-menopausal women. It is uncommon in men and children.
    • Symptoms of lichen sclerosus include small white, shiny, smooth spots on the skin that grow into bigger plaques that become thin and crinkled. The skin may tear easily, and bright red or purple bruises are common. There may also be itching, bleeding, and blisters.
    • The cause of lichen sclerosus is unknown but may be the result of an overactive immune system and hormone problems.
    • Lichen sclerosus is not contagious.
    • Lesions from lichen sclerosys on the arms or upper body usually go away without treatment. If lesions appear on the genitals, treatment for women involves topical prescription-strength steroid cream or ointment.
    • Skin scarred by lichen sclerosus is somewhat more likely to develop skin cancer.

    What is lichen sclerosus?

    Lichen sclerosus is a long-term problem of the skin. It mostly affects the genital and perianal areas. Sometimes, lichen sclerosus appears on the upper body, breasts, and upper arms.

    Who gets lichen sclerosus?

    Lichen sclerosus appears in:

    • Women (often after menopause)
    • Men (uncommon)
    • Children (rare).

    What are the symptoms?

    Early in the disease, small white spots appear on the skin. The spots are usually shiny and smooth. Later, the spots grow into bigger plaques. The skin on the plaques becomes thin and crinkled. Then, the skin may tear easily, and bright red or purple bruises are common. Sometimes, the skin becomes scarred. If the disease is a mild case, there may be no symptoms.

    Other symptoms are:

    • Itching (very common)
    • Discomfort or pain
    • Bleeding
    • Blisters.

    What causes lichen sclerosus?

    Doctors don't know the exact cause of lichen sclerosus. Some doctors think a too active immune system and hormone problems may play a role. It is also thought that people inherit the likelihood of getting the disease. Sometimes, lichen sclerosus appears on skin that has been damaged or scarred from some other previous injury.

    Lichen sclerosus is not contagious (it can't be caught from another person).

    How is it diagnosed?

    Doctors can look at severe lichen sclerosus and know what it is. But usually, a doctor takes a small piece of the affected skin (biopsy) and looks at it under a microscope. This allows doctors to make sure that it is not a different disease.

    How is it treated?

    If you have patches on the arms or upper body, they usually don't need treatment. The lesions go away over time.

    Lichen sclerosus of the genital skin should be treated. Even if it isn't painful or itchy, the affected areas can scar. This can cause problems with urination or sex. There is also a very small chance that skin cancer may develop in the affected skin.

    Surgery is normally a good option for men. Circumcision (removing the foreskin on the penis) is the most widely used therapy for men with lichen sclerosus. The disease usually does not come back. Surgery is not a good option for women. When the lichen sclerosus lesions are removed from the genitals of women and girls, they usually come back.

    Treatment also includes using very strong prescription-strength steroid cream or ointment on the skin. You put these creams on the spots every day for several months. This stops the itching. Then you use the cream or ointment two times a week for a long time to keep the disease from coming back. Treatment does not fix the scarring that may have already occurred.

    You need regular followup by a doctor because using these creams and ointments for a long time can cause:

    • Thinning and redness of the skin
    • Stretch marks where the cream is applied
    • Genital yeast infections.

    Sometimes, you don't get better when using the steroid creams. Some things that can keep symptoms from clearing up are:

    • Infection
    • Allergy to the medication.

    When creams and ointments don't work, your doctor may suggest:

    • Retinoids, or vitamin A-like drugs
    • Tacrolimus ointment
    • Ultraviolet light treatments (not used on skin of the genitals).

    If you need medicine, ask your doctor:

    • How does the medicine work?
    • What are its side effects?
    • Why is it the best treatment for my lichen sclerosus?

    If a young girl gets lichen sclerosis, she usually does not require lifelong treatment. Lichen sclerosus sometimes goes away at puberty. Scarring and changes in skin color may remain.

    What causes lichen sclerosus?

    Doctors don't know the exact cause of lichen sclerosus. Some doctors think a too active immune system and hormone problems may play a role. It is also thought that people inherit the likelihood of getting the disease. Sometimes, lichen sclerosus appears on skin that has been damaged or scarred from some other previous injury.

    Lichen sclerosus is not contagious (it can't be caught from another person).

    How is it diagnosed?

    Doctors can look at severe lichen sclerosus and know what it is. But usually, a doctor takes a small piece of the affected skin (biopsy) and looks at it under a microscope. This allows doctors to make sure that it is not a different disease.

    How is it treated?

    If you have patches on the arms or upper body, they usually don't need treatment. The lesions go away over time.

    Lichen sclerosus of the genital skin should be treated. Even if it isn't painful or itchy, the affected areas can scar. This can cause problems with urination or sex. There is also a very small chance that skin cancer may develop in the affected skin.

    Surgery is normally a good option for men. Circumcision (removing the foreskin on the penis) is the most widely used therapy for men with lichen sclerosus. The disease usually does not come back. Surgery is not a good option for women. When the lichen sclerosus lesions are removed from the genitals of women and girls, they usually come back.

    Treatment also includes using very strong prescription-strength steroid cream or ointment on the skin. You put these creams on the spots every day for several months. This stops the itching. Then you use the cream or ointment two times a week for a long time to keep the disease from coming back. Treatment does not fix the scarring that may have already occurred.

    You need regular followup by a doctor because using these creams and ointments for a long time can cause:

    • Thinning and redness of the skin
    • Stretch marks where the cream is applied
    • Genital yeast infections.

    Sometimes, you don't get better when using the steroid creams. Some things that can keep symptoms from clearing up are:

    • Infection
    • Allergy to the medication.

    When creams and ointments don't work, your doctor may suggest:

    • Retinoids, or vitamin A-like drugs
    • Tacrolimus ointment
    • Ultraviolet light treatments (not used on skin of the genitals).

    If you need medicine, ask your doctor:

    • How does the medicine work?
    • What are its side effects?
    • Why is it the best treatment for my lichen sclerosus?

    If a young girl gets lichen sclerosis, she usually does not require lifelong treatment. Lichen sclerosus sometimes goes away at puberty. Scarring and changes in skin color may remain.

    Source: http://www.rxlist.com

    If you have patches on the arms or upper body, they usually don't need treatment. The lesions go away over time.

    Lichen sclerosus of the genital skin should be treated. Even if it isn't painful or itchy, the affected areas can scar. This can cause problems with urination or sex. There is also a very small chance that skin cancer may develop in the affected skin.

    Surgery is normally a good option for men. Circumcision (removing the foreskin on the penis) is the most widely used therapy for men with lichen sclerosus. The disease usually does not come back. Surgery is not a good option for women. When the lichen sclerosus lesions are removed from the genitals of women and girls, they usually come back.

    Treatment also includes using very strong prescription-strength steroid cream or ointment on the skin. You put these creams on the spots every day for several months. This stops the itching. Then you use the cream or ointment two times a week for a long time to keep the disease from coming back. Treatment does not fix the scarring that may have already occurred.

    You need regular followup by a doctor because using these creams and ointments for a long time can cause:

    • Thinning and redness of the skin
    • Stretch marks where the cream is applied
    • Genital yeast infections.

    Sometimes, you don't get better when using the steroid creams. Some things that can keep symptoms from clearing up are:

    • Infection
    • Allergy to the medication.

    When creams and ointments don't work, your doctor may suggest:

    • Retinoids, or vitamin A-like drugs
    • Tacrolimus ointment
    • Ultraviolet light treatments (not used on skin of the genitals).

    If you need medicine, ask your doctor:

    • How does the medicine work?
    • What are its side effects?
    • Why is it the best treatment for my lichen sclerosus?

    If a young girl gets lichen sclerosis, she usually does not require lifelong treatment. Lichen sclerosus sometimes goes away at puberty. Scarring and changes in skin color may remain.

    Source: http://www.rxlist.com

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