Lichen sclerosus is a dermatologic condition characterised by genital itching leading to atrophic, thinned skin. Is is diagnosed clinically and treated with corticosteroids.

Pathophysiology

• Possibly autoimmune inflammatory process

Contextual Factors

• Possible genetic factor
• Prepubertal female
• Perimenopauseal or postmenopausal female

Clinical Manifestation

• Skin fragility, bruising, blistering
  • Thin, white, wrinkled skin
• Mild to severe itching
  • Exocriations, erosions, fissures from severe pruritus
• Dysuria
• Dyspareunia
• Painful defecation

Complications

• Females: total destruction of the labia minora and clitoris
• Males: phimosis or foreskin fusion to the coronal sulcus

Diagnosis

• Clinical
• Punch biopsy to rule out squamous cell carcinoma

Treatment

• Superpotent topical corticosteroids