Lichen
sclerosus (also known as lichen sclerosus
et atrophicus, LS&A or white spot disease)
is an uncommon disease of unknown cause that results
in white and red patches on the skin, which may
be associated with ulceration, erosions and scarring.
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Lichen sclerosus can
affect any area of the skin, but it is most
common on the female genital skin or the male
foreskin and penile skin. In men, this has
traditionally been known as balanitis xerotica
obliterans (BXO). |
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There may be marked
itching or the condition may be without any
symptoms. There may also be thinning and shrinkage
of the genital area that can make sexual intercourse
painful or difficult. Thinning of the skin
may also occur. |
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The disease can last
for a long time. Occasionally, spontaneous
cure may ensue, particularly in young girls. |
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Lichen sclerosus is
usually treated with application of potent
steroids, which may cause relief and prevent
scarring. |
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In severe cases or those
with significant pain or rapid progression,
oral immunosuppressant medication are necessary
to control the disease (hydroxychloroquine,
methotrexate, dapsone and mycophenolate mofetil
are a few options). |
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Narrowed vaginal tissues
can be expanded with vaginal expanders or
surgery. |
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Occasionally, squamous
cell cancer may develop in areas of chronic
lichen sclerosus. |
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Periodic consultation
and follow up with a physician experienced
in the treatment of lichen sclerosus is important
to treat this condition effectively, avoid
complications and prevent secondary skin cancers. |
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