Lichen sclerosus is a rare, non-contagious skin disease. Above all, it affects adult women, more rarely men and children. Especially the genital mucous membranes are affected, the skin can itch and feel sore. The therapy is usually in the use of cortisone-containing preparations to relieve the symptoms, a cure of the disease is currently not possible. Read more about symptoms and treatment of lichen sclerosus.
Lichen sclerosus: description
Lichen sclerosus is a rare, inflammatory connective tissue disease. When whitish or in groups, whitish, hard skin knots arise. These can fuse together and remind you of scar tissue. The lichen sclerosus is not contagious, its causes are not yet clearly known.
Most commonly, the genital region is affected, mostly in adult women. The disease can also occur in the back-shoulder region, on the inner thighs or in the area around the anus. If only the genitals are affected, it is also called lichen sclerosus genitalis. Although lichen sclerosus is non-communicable, many people have relapses to go to the doctor with the disease, so many patients are not or late recognized.
Lichen sclerosus: symptoms
Most people experience a severe itching in genital lichen sclerosus. This often occurs in batches, but sometimes it is not or only weakly pronounced. The skin hardens, it is particularly vulnerable and can therefore, for example, by scratching, easily tear, bleed and inflame. By scratching it can bleed into the subcutaneous tissue, so that the lichen sclerosus undermines red and appears crusty. Mostly, however, it is whitish-scarred without, or with less skin pigmentation.
Due to scarring skin areas can shrink (atrophy), which can regress in the woman’s labia. Since the vaginal entrance is often affected, the sexual act can be very painful and unpleasant. In man, due to the hardening (sclerosis) of the skin, the foreskin is no longer, or push back only with difficulty. This makes intimate hygiene difficult. Infections under the foreskin can then trigger permanent inflammation of the glans skin (balanitis). The skin tears easily, which is also painful and interferes with sexual intercourse. Often the erection is already painful.
Even when urinating or defecating pain may occur. Due to the scarred narrowing of the urethra, the urinary stream may be weakened.
Lichen sclerosus: causes and risk factors
The exact cause of lichen sclerosus is still unclear. Experts discuss various theories, ranging from genetic backgrounds to possible infections to a hormonal imbalance. However, none of these theories is sufficiently proven. It is clear that the skin structure in lichen sclerosus is changed in the long term and reminds of scar tissue, because the cells, which are responsible for the production of connective and scar tissue (fibroblasts), are overly active.
Also, the distribution of small capillaries (Capillaries) and the amount of hyaluronic acid, an important component of the connective tissue, is disturbed in the morbidly altered areas of the skin.
The theory of hormonal influence is supported by the fact that women who take the pill before the menopause have an increased risk of lichen sclerosus. Other scientists see a connection of the lichen sclerosus with autoimmune diseases – ie disorders of the body’s immune system – such as the autoimmune thyroiditis Hashimoto (hypothyroidism).
According to the current state of science, lichen sclerosus is neither contagious nor transmissible through sexual intercourse. Menopausal women are the most frequently affected, less common are children, men and boys before puberty. Lichen sclerosus is the most common cause of non-congenital foreskin constriction.
Lichen sclerosus: examinations and diagnosis
The first suspicion of lichen sclerosus, the doctor can usually comment on the assessment of the affected bodies. However, there are a variety of similar-looking diseases, so that any further suspected diagnosis must always be followed. In order to ensure the diagnosis of lichen sclerosus and to rule out any infectious or malignant lesions, the doctor takes a skin sample, which is examined in the laboratory under the microscope.
Lichen sclerosus: treatment
Since the cause of lichen sclerosus is not yet known, the therapy is only generally directed against the skin change. Often, cortisone creams are used, which, especially in the genital area, can relieve irritating itching and reduce inflammation. To improve the effect, the doctor can inject the cortisone directly into the skin of the affected areas.
In addition, the doctor may administer certain anti-immune creams on an experimental basis. Greasy skin creams are suitable for other, non-genital skin areas to relieve the feeling of tightness and dryness. In boys or men as early as possible, the diseased penile foreskin should be removed by circumcision. Stronger skin lesions are often operated on because of the increased skin cancer risk.
Lichen sclerosus: disease course and prognosis
Lichen sclerosus is a chronic, slowly progressive disease. The treatment depends on the disease phases and the current symptoms, a cure is currently not possible. Unfortunately, currently known treatment options are not equally effective in all sufferers, so the pain of suffering from lichen sclerosus can vary widely from patient to patient.
Basically, lichen sclerosus is a benign disease. People with Lichen sclerosus however, have an increased risk of developing skin cancer. For those affected, regular visits to the dermatologist are important in order to identify and treat possible malignant skin changes at an early stage.