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Lichen Sclerosus !lI-kun-sklu-!rO-sus-et-+A-!trO-fi-kus

by Peter C. Schalock, MD

Lichen sclerosus is a disorder that tends to cause itching and can cause scarring in the area around the anus and genitals.

The cause of lichen sclerosis is unknown, but it may involve the immune system attacking some of the body's own tissues (called an autoimmune disorder). This disorder typically affects the area around the anus and genitals, but it can rarely be found on other areas of the body.

Symptoms

At first, the skin around the anus and genitals tends to bruise and may blister. Itching, sometimes severe, is typical. After some time, the skin can thin, lose its normal color, and develop cracks and scales. In some people, the disorder develops differently, causing skin thickening. Eventually, any form of lichen sclerosus that is chronic can scar, causing distortion of the normal structures of the area. Sometimes the appearance of lichen sclerosus in a child can resemble the effects of sexual abuse. Rarely, squamous cell carcinoma (a skin cancer) develops.

Diagnosis

  • A doctor's evaluation

  • Sometimes skin biopsy

Doctors typically base the diagnosis on how the rash looks and where it appears on the body. Occasionally, doctors do a biopsy (examination of a tissue sample under a microscope).

Treatment

  • Corticosteroid creams or ointments

Strong corticosteroid creams or ointments may need to be applied to the skin. Because this disorder is typically incurable and causes scarring, people are treated long-term and examined periodically for skin cancer.

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