Lichen sclerosus

Lichen sclerosis (LS) is a chronic inflammatory skin disease that causes substantial discomfort and morbidity, most commonly in adult women but also in men and children. Any skin site may be affected (and, rarely, the oral mucosa) but lichen sclerosus is most common in the anogenital area, where it causes intractable itching and soreness. The symptoms of LS are thinning skin, white patches of skin, itching and/or burning, painful sexual intercourse, and sores or lesions resulting from scratching. If left untreated, LS can result in fusing of the skin, atrophy, and narrowing of the vagina. Progression to destructive scarring is common. There is increased risk of developing vulval cancer and there are links with penile cancer.

Lichen sclerosus can occur without symptoms and the exact prevalence is uncertain. It occurs most commonly in women at times of low sex hormone output. The underlying cause is unknown, but there seems to be a genetic susceptibility and a link with autoimmune mechanisms.

The wart virus and the spirochaete borrelia have been suggested but not substantiated as infective triggers. Trauma, injury and sexual abuse have been suggested as possible triggers of symptoms in genetically predisposed people.

The most common sufferers of LS are post-menopausal women, although the disease can strike women of any age -- including young girls. In addition, there are many known cases of men and boys diagnosed with LS.