What Kind of Disorder Is Lichen Sclerosus?

Question

What kind of disorder is lichen sclerosus? Is it rare, and can it become cancerous?

Answer

Lichen sclerosis (LS) is a chronic skin disorder that mainly affects postmenopausal women, although premenopausal women and men can still experience the condition. It causes irritated skin around external genitalia such as the vulva, usually in white patches where the skin becomes thin, wrinkled, and extremely sensitive [1]. Women experiencing lichen sclerosus often experience flare-ups or intense itching attacks. Although lichen sclerosus is not contagious and cannot be transmitted sexually, minor abrasions and chaffing may lead to bleeding, tearing, and blistering of affected areas [1].

The condition is often confused with fibromyalgia, which is characterized by widespread musculoskeletal pain, and scleroderma, which is a chronic connective tissue disease. Some common symptoms of these conditions include muscle pain, fatigue, and mild flu-like symptoms. While some research suggests it could be tied to genetics, most researchers believe LS is a disorder of the immunological system. Understanding the causes of this disorder is still in development, and it is considered rare.

Treatment for LS usually involves ointments or creams that can alleviate itching [1]. The most commonly prescribed creams are corticosteroids, which relieve inflamed body areas [1]. Other treatments include immune-modulating medications and ultraviolet light therapy, although the latter is only recommended for non-genital areas [1]. The National Institutes of Health (NIH) recommends seeing a doctor every six to 12 months for lichen sclerosus to evaluate the condition and determine the best treatment.

In some cases, lichen sclerosus can lead to cancer. Vulvar squamous cell carcinoma was diagnosed in 3.5 to 7% of women with LS, but up to 65% of vulvar carcinomas are diagnosed from skin affected by LS [1]. The risk of cancer increases with time. At two years, a person has a vulvar cancer risk of 1.2%, and at 25 years the risk jumps to 36.8% [1]. Since it can take many years for cancer to develop, it is believed that with proper treatment and frequent visits to a doctor, cancer can be avoided [1]. Some cases of lichen sclerosus improve on their own, but in more severe cases, doctors may recommend surgical removal of the affected skin layers [1]. This is more common for patients with penises, as patients with vulvas can redevelop the condition after surgery. Many of these treatments, such as ultraviolet light therapy and corticosteroid ointments, are sometimes used in combination with one another.

Research regarding lichen sclerosus is still incomplete, so to get proper treatment, you should seek doctors or specialists who can recommend the best option. Check out the Association for Lichen Sclerosus and Vulval Health’s website for more information on how to find a doctor specializing in the condition.

 

Sources

[1] De Luca, D. A., Papara, C., Vorobyev, A., Staiger, H., Bieber, K., Thaçi, D., & Ludwig, R. J. (2023). Lichen sclerosus: The 2023 update. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1106318


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