Lichen Sclerosus (LS) is a lymphocyte-mediated inflammatory dermatosis
brought about by the action of lymphocytes. It is characterized by delicate,
patchy white skin
In majority of those affected by lichen sclerosis, inflammation
is typically located
in the ano-genital region involving the skin on vulva in women and the skin
around anus and foreskin of penis in men. Post menopausal women are the ones
most prone to lichen sclerosus. Among boys, and adult males, it is more
frequently seen in those who are uncircumcised. In children, the disease is
rare and resolves on its own after the attainment of puberty
Lichen sclerosus is non-contagious and does not spread through
intercourse. Sometimes the disease resolves on its own. If it does not,
treatment must be ensured to avoid complications.
Lichen sclerosus, at times, does not manifest
any symptoms at all.
Symptoms of lichen sclerosus include -
Severe itching (pruritus
) and discomfort
Smooth white spots that may transform into blotchy, wrinkled patches
Easy bruising / tearing of skin
Painful intercourse, if the disease is in the vulval region
, blistering or ulcerated
lesions in severe cases
In severe cases, sexual intercourse becomes extremely painful
for women due to itching and tenderness. Besides this, the vaginal opening
may be considerably narrowed due to scarring.
In uncircumcised men lichen sclerosus causes tightening
and thinning of the foreskin which can make urination
The exact cause of lichen sclerosus is unclear but a
decrease in sex
or an over-active immune system have been implicated as the
Previous skin damage is likely to raise the likelihood of
disease occurrence at the affected spot.
Persistence of lichen sclerosus in one location of the
skin raises the chances of skin
although there is no conclusive report on the same. It is
therefore necessary to go for regular health checkups once a year to monitor
for changes in the skin.
Diagnosis & Treatments
A physical examination
is the first step towards the diagnosis of lichen sclerosus. A biopsy may be
done in some cases to confirm diagnosis. It is done by the surgical removal of
skin from the affected spot and examining it under the microscope. The disease
often resolves on its own and treatment is necessary only if genital parts are
If scarring is
observed around the genital area then treatment would be recommended to reduce
itching and also to reduce scarring and improve skin appearance. Surgery in the
genital area is generally not recommended for women. In severe cases it may be
done but only after controlling the condition through medications.
Some common treatments
include - Corticosteroids
topical application recommended. To be discontinued after the recommended
period of time or in case of side effects
Phototherapy -Ultraviolet light treatment on areas other than genital areas
Topical sex hormones
Removal of foreskin (circumcision
) through surgery in
men. Surgical management in the genital area is not recommended for women as
the condition is likely to recur.
Monitoring and 6 monthone year follow ups are required in
persistent cases. This is to look out for any changes that may occur.