lichen sclerosis

• related: OBGYN, lichen simplex

• 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.