Lichen sclerosus
| Lichen sclerosus | |
|---|---|
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| Micrograph of lichen sclerosus showing the characteristic subepithelial sclerosus (right/bottom of image). H&E stain. | |
| Classification and external resources | |
| Specialty | dermatology |
| ICD-10 | L90.0 |
| ICD-9-CM | 701.0 |
| eMedicine | derm/234 |
| MeSH | D018459 |
Lichen sclerosus (LS), and also known as lichen sclerosus et atrophicus (LSetA) [also termed, incorrectly, "Lichen sclerosis et atrophicus"] is a disease of unknown cause that results in white patches on the skin, which may cause scarring on and around genital or sometimes other skin. There is a bimodal age distribution in the incidence of LS. It occurs in females with an average age of diagnosis of 7.6 years in girls and 60 years old in women. The average age of diagnosis in boys is 9–11 years old.
Several risk factors have been proposed, including autoimmune diseases, infections and genetic predisposition. There is evidence that LS can be associated with thyroid disease.
Women are more commonly affected than men (10 to 1 ratio), particularly around and after menopause, but younger women or girls may also develop the disease. The condition most commonly occurs on the vulva and around the anus with ivory-white elevations that may be flat and glistening. 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 may make coitus, urination, and defecation painful.
In males, the disease may take the form of whitish thickening of the foreskin, which cannot be retracted easily (phimosis). In contrast to women, there is no perianal involvement. In men, this genital involvement has traditionally been known as balanitis xerotica obliterans (BXO).
Only 6% of LS are isolated extragenital lesions. On the non-genital skin, the disease may manifest as porcelain-white spots with small visible plugs inside the orifices of hair follicles or sweat glands on the surface. Thinning of the skin may also occur. [The appearance of the skin, as symptoms listed here, do not include those that may appear in members of some minority groups; I.E. "African-Americans", or others whose skin contains more melanin, may display skin symptoms that appear different than those described here, which would seem to be those that "whites" or Caucasians would most likely display.{Article may need editing to include symptoms displayed by a more diverse cross-section of suffers.}]
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