Lichen sclerosus

(Lichen sclerosus et atrophicus)

• inflammatory dermatosis

• occurs in all age groups

• particularly affects anogenital region

• more common in females

Presentation

• atrophic ivory white macules with well defined edge

• vulva, glans penis, foreskin or perianal skin

• telangectasia may be seen on surface

• lesions itchy but may be sore

• longstanding vulval lesions may be associated with fissuring, marked loss of architecture - labia minora may become fused

• early lesions in young girls may present as haemorrhagic blisters

Complications

• phimosis if involves foreskin

• fissuring perianal lesions leading to constipation

• squamous cell carcinoma in long-standing lesions

Investigation

• may require biopsy to exclude lichen planus and Paget's disease

Treatment

• potent topical steroids

• hydroxychloroquine

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