Lichen Sclerosus

Lichen sclerosus (LS) is a chronic inflammatory skin disorder primarily affecting genital and anal areas, causing thin, white, porcelain-like patches. It leads to intense itching, pain, and scarring, more common in postmenopausal women but also seen in men and children.?

The exact cause remains unclear, linked to autoimmune factors, genetic predisposition, and hormonal influences, with T-cell infiltration driving fibrosis and tissue atrophy. Lesions start as red spots evolve into hypopigmented plaques, potentially causing fusion of skin folds, phimosis in men, or a narrowed vaginal opening in women. Untreated, it risks functional issues like painful intercourse or urination and squamous cell carcinoma (up to 5% in genital cases).?

Diagnosis relies on clinical exam and biopsy showing dermal sclerosis and lymphocytic infiltrate. First-line treatment uses high-potency topical corticosteroids like clobetasol to reduce inflammation and symptoms, often with long-term maintenance. Emollients soothe skin, while surgery addresses severe scarring. Regular follow-up prevents complications and monitors for malignancy. Early intervention improves quality of life significantly.