lichen sclerosus

Lichen Sclerosus
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What Is Lichen Sclerosus?

Lichen sclerosus (LIKE-in skler-O-sus) is a chronic inflammatory skin disorder that is most common in women, but can affect men as well. It usually affects the vulva (the outer genitalia or sex organ) and the anal area. Lichen sclerosus appears predominantly in postmenopausal women. Occasionally, lichen sclerosus is seen on other parts of the body, especially the upper body, breasts, and upper arms.

The symptoms are the same in children and adults. Early in the disease, small, subtle white spots appear. These areas are usually slightly shiny and smooth. As time goes on, the spots develop into bigger patches, and the skin surface becomes thinned and crinkled. As a result, the skin tears easily, and bright red or purple discoloration from bleeding inside the skin is common. More severe cases of lichen sclerosus produce scarring that may cause the inner lips of the vulva to shrink and disappear, the clitoris to become covered with scar tissue, and the opening of the vagina to narrow.

How Common Is Lichen Sclerosus?

Although definitive data are not available, lichen sclerosus is considered a rare disorder that can develop in people of all ages. It usually appears in postmenopausal women and primarily affects the vulva. It is uncommon for women who have vulvar lichen sclerosus to have the disease on other skin surfaces. The disease is much less common in childhood.

It is very uncommon in men.

What Are the Symptoms of Lichen Sclerosus?

Symptoms vary depending on the area affected. Patients experience different degrees of discomfort. When lichen sclerosus occurs on parts of the body other than the genital area, most often there are no symptoms, other than itching. If the disease is severe, bleeding, tearing, and blistering caused by rubbing or bumping the skin can cause pain.

Very mild lichen sclerosus of the genital area often causes no symptoms at all. If the disease worsens, itching is the most common symptom. Rarely, lichen sclerosus of the vulva may cause extreme itching that interferes with sleep and daily activities. Rubbing or scratching to relieve the itching can create painful sores and bruising, so that many women must avoid sexual intercourse, tight clothing, tampons, riding bicycles, and other common activities that involve pressure or friction. Urination can be accompanied by burning or pain, and bleeding can occur, especially during intercourse. When lichen sclerosus develops around the anus, the discomfort can lead to constipation that is difficult to relieve. This is particularly common in children. It is important to note that the signs of lichen sclerosus in children may sometimes be confused with those of sexual abuse

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