Lichen Sclerosis

Also called the White patch disease, the condition is characterized by the appearance of small rounded white patches over the skin. It mainly involves the genital area.

Who is Prone to Getting These Skin Patches?

Anyone can get this condition. However, it is commoner in young girls who have not started menstruating or in post menopausal women .

The condition is less common in males. However, young boys or older male population may show such patches over their genital area.

Appearance of the Patch and Other Symptoms

Location of these skin lesions is mainly the genital area, including the vulva, the penile foreskin, adjoining areas or the skin around the anal sphincter.

  • Pearly white patches may appear, either solitary or in groups. Two or more patches may gradually enlarge and fuse together to give a bigger lesion.
  • The patch may be slightly raised and be pearly white in appearance in the beginning. Gradually, the skin out there thins out and the patch may appear wrinkled or blotchy.
  • As the affected skin gets involved and becomes weaker and thinner, the skin may get teared due to stretching. Ulcers may get formed. In severe cases, bleeding may occur.
  • The patches may be itchy. Sometimes they are very itchy. There may be pain or discomfort over them.
  • They area dry or sore to touch. Sometimes, this dry or sore feeling is the main complain which brings the patient to the doctor.
  • You may get pain whenever the skin out there stretches, as during intercourse or during defecation.

What Causes Lichen Sclerosis?

The exact cause why you get these patches is not known. However, hormonal imbalances are seen to be associated with the occurence of this condition.

This may be the reason why the condition improves in young girls and boys as they approach puberty.

Areas that have been previously injured or infected are prone to getting these patches. This may suggest that the occurrence of the patches may be linked to an over active immune reaction in those particular local sites of the skin.

Lichen Sclerosis is not contagious. It is not an STD. It does not spread through touching or sexual intercourse. This further tells us that the disease is from within the body, not a germ from outside.

Treatment of the condition is essential. If left untreated, complication may arise.

  • The affected skin may first thin out. Gradually, scarring occurs. This may sort of shrink the skin over the vulva or the fore skin over the penis.
  • As the vulval skin shrinks, the orifice becomes narrow, making it, both, difficult and painful to go for intercourse.
  • Similarly, it may become difficult to retract the foreskin, making it painful to go for sexual activities or even urination.
  • The affected skin becomes sensitive and vulnerable to tears and bleeding.
  • Lichen sclerosis is a chronic irritation over the skin. This may make the affected skin portions prone to developing cancers.

Making a Diagnosis

The condition is diagnosed mainly on physical examination by a dermatologist.

Rarely, your doctor may take a little biopsy from the affected area and visualize the cells under a microscope.

Management

In mild cases, if you don’t have itching and no scarring is visible, medical treatment may not be needed.

Just keep the area clean and moisturize it thoroughly. The lesions are likely to subside on their own with time.

However, is more advanced cases, where you have itching, or scarring over the skin develops or else, vast areas of the skin are affected, treatment may be started.

Corticosteroids are used in the form of cream and ointment over the affected areas. They control itching. Also, they prevent scarring, which may be the cause of further functional problems.

The cream may be used daily in initial phase. Later on, twice a week application is suggested to keep control over the disease progress.

Immune modulating medications are sometimes given, especially in cases where steroids don’t give good results.

Surgical Treatment

Surgical removal of the affected skin is not done. This is so because there may be recurrence of the condition over the new skin after surgery.