View source for Lichen sclerosus

==Background==
*A benign, chronic, progressive dermatologic condition characterized by marked inflammation, epithelial thinning, and distinctive dermal changes accompanied by symptoms of pruritus and pain
*Typically affects postmenopausal women, however it does sometimes occur in men, children, and premenopausal women
*Thought to be related to low estrogen states

==Clinical Features==
[[File:Lichen sclerosus.jpg|thumb|Lichen sclerosus showing an ivory white coloring in the vulva, and also stretching downward to the perineum.]]
*Skin becomes thin, wrinkles, and whitened
*In males, most commonly affects glans or foreskin<ref>Teichman JM et al.  Noninfectious Penile Lesions.  Am Fam Physician. 2010 Jan 15;81(2):167-174.</ref>
*Most common symptoms include itching and pain at the affected areas, most commonly the clitoris and labia (although any skin surface can be affected)
*Other symptoms include anal discomfort, dyspareunia, and dysuria

==Differential Diagnosis==
*[[Candidiasis]]
*[[Lichen planus]]
*[[Psoriasis]]
*[[Dermatitis]]

{{Vulvovaginitis DDX}}

==Evaluation==
*Biopsy — A vulvar punch biopsy is taken to demonstrate atypical cell histology
*Histopathology — Epidermis is thinned, areas of hyperkeratosis may be observed. Early lesions may show irregular epidermal acanthosis
*Clinical judgment should guide the diagnosis and treatment of LS when biopsy results are not specific

==Management==
*Behavioral changes: good hygiene, avoid scratching area
*topical steroids such as clobetasol proprionate

==Disposition==
*Can be chronic
*Increases chance of vulvar squamous cell carcinoma

==See Also==

==External Links==

==References==
<references/>
*https://en.wikipedia.org/wiki/Lichen_sclerosus
[[Category:Dermatology]]