Lichen sclerosus is a skin's chronic inflammatory disease, characterised by papules or atrophic white patches.
It fundamentally affects postmenopausal women but it can develop in both genders and through other ages. The prevalence in the general population is stimated to be in 1 of every 300-1.000 individuals.
The cause is still unknown but it seems to be caused by an overactive immune system or hormonal imbalance. It is not contagious and does not disseminate via sexual intercourse.
Persons affected by lichen sclerosus can be asymptomatic. If symptoms arise, they can be the following: white and plain areas on the skin, reddening of the area and itchiness (prurito). Although it can affect extra-genital areas, the majority of cases affect the genitalia and can cause pain and sexual intercourse discomfort. In women with intense and prolonged symptoms, atrophy and retraction of the vulva can appear. The labia minora fuses together and disappear, the clitoris blurs away and the vaginal opening orifice can even contract and occlude. Despite it, the vaginal mucous membrane remains unaffected. In more severe and evoluted cases, cysts and tearing that can produce bleeding is associated. In men, non-circumcised are more affected due to the lesions appearing in the prepuce.
A diagnosis is reached via clinical history and the affected zone exploration. It can be necessary to do a biopsy to confirm it.
A very effective treatment doesn't exist but the doctor can recommend creams or ointments to regain the skin's normal colouration and diminish the predisposition to form scars. Potent topical corticosteroids control the symptoms and improve its evolution, despite potentially increasing the skin's atrophy if used for a prolonged time. Strogen creams at 0.01%, topical progesterone at 2% or substitutive hormonal therapy in postmenopausal people, helps improving the skin's state but are not enough as a treatment by itself.
As the disease can reappear over time, it requires the monitoring of the case over time.
