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Lichen Sclerosus: Causes, Symptoms, and Treatment

What is Lichen Sclerosus

Lichen Sclerosus is also known as Lichen Sclerosis (or Lichen Sclerosus et atrophicus). It is a painful skin condition that typically affects the vulva (or penis) and anus. It results in white patches on the skin, which causes scarring on and around the genital skin.

Causes of Lichen Sclerosis:

In most cases, the cause remains unknown. It is found to be an immunologically mediated disease. There are several factors found responsible for the development of lichen sclerosis, such as auto-immune diseases, infections, and genetic components. It may be associated with thyroid disease in some patients.

Incidence:

Women are more commonly affected than men (10:1), particularly in young girls (prepubertal) and postmenopausal women. Children are rarely affected.

Areas affected:

  • In females the vulva and anus
  • In males foreskin of the penis
  • Non-genital areas involve hair follicles or sweat glands on the surface of skin, breasts, and underarms.

Signs and symptoms of Lichen Sclerosus:

If the disease is a mild case, there may be no symptoms.

In the early stage, small white spots appear on the skin, which is shiny, and smooth in an appearance later on the spots grow into bigger patches. The skin on the patches becomes thin and wrinkled. Then the skin tears easily, and bright red or purple bruises are common. Sometimes, the skin becomes scarred.

InLichen Sclerosis the main symptom is itching along with painful coition, urination, and defecation.

In males, Lichen Sclerosis can lead to whitish thickening of the foreskin of the penis causing phimosis (failure of foreskin to be fully retracted from the head of the penis)

Diagnosis:

Lichen Sclerosis diagnosis is done by experienced clinical examination and
A biopsy of the skin may be required to confirm the diagnosis.

Conventional Treatment:

  • Application of strong cortisone or immunosuppressant (ointments or creams) is suggested such as clobetasol propionate and tacrolimus
  • Topical estrogen creams are not effective for Lichen Sclerosus but may be prescribed for postmenopausal atrophy (dry, thinned, and sensitive vulval and vaginal tissues due to hormonal deficiency).
  • Retinoid, or vitamin A-like drugs
  • Surgery to remove entire vulva in severe cases, vulvar cancer or pre-cancer.
  • Surgery that removes the patches in women is of no use as it comes back
  • Circumcision in men
  • Ultraviolet light therapy (not used on the skin of the genitals).

Homeopathic treatment:

Homeopathic treatment entails medication based on the understanding of the immune status of the patients, and other genetic, hormonal, stress-related factors. Some of the commonly used medicines include ultra-small doses of potentized mercury compounds, gold salts, Thuja occidentalis, some nosodes, etc.

Prognosis of Lichen Sclerosis:

There is an increased risk of cancer in the long term; Women with Lichen Sclerosis may develop vulvar carcinoma. In advanced cases, skin that has been scarred as a result of Lichen Sclerosis may cause sexual difficulties or problems in passing urine

Some general measures:

  • Use of moisturizers or bland creams
  • Avoid soap, bubble baths, scented soap, detergents, perfumes, etc, to the vulva. These may irritate the skin and make symptoms worse.
  • Lubricants are useful during sex if having sex is painful.
  • Avoid tight clothing and use cotton undergarments

Homeopathic management:

Homeopathic medicines are effective for the management of Lichen Sclerosis. The medicines help to reduce inflammation, reduce itching and help to control the pathology and restrict the spread of the disease. They give good relief in the pain, burning, and discharge.

Homeopathic medicines help in long-term remissions (disease-free intervals). Persons can remain symptom-free with the help of homeopathic remedies.

In the case of phimosis, a surgical procedure has to be carried out. In the case of Lichen Sclerosus turning malignant, homeopathy will have no scope in treatment.

The medicines are decided after integrating all this information and help in reducing the symptoms, halting the pathology, and giving long-term remissions.

 

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Lichen Planus Case Studies

A 46-year-old male patient from the USA, Dr. R. P. (PIN: 26560) observed the development of a few skin eruptions, which were itchy and spreading. He visited a skin specialist; the biopsy of the same confirmed that he had Lichen planus. The skin specialist prescribed him a topical steroid.

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