Lichen Sclerosus Et Atrophicus in Young Subjects.*

Kindler, Theresa

doi:10.1111/j.1365-2133.1953.tb13749.x

Cited by 32 publications

(4 citation statements)

References 14 publications

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“…There have been many observations of lichen sclerosus occurring as a Kö bner phenomenon. Non-genital lichen sclerosus occurs in response to a variety of types of tissue damage: scarring; solar and therapeutic irradiation; pressure under areas of tight clothing, for example, brassiere straps and belts; where body parts rub, for example, pendulous breasts against the chest wall and in acrochorda (59)(60)(61)(62)(63)(64)(65)(66)(67) . Genital lichen sclerosus is associated with many conditions that give rise to local itch, for example, vulvovaginal candidiasis and trichomoniliasis in women and nonspecific vulvovaginitis in girls, pinworm, urinary tract infection, diabetes, and obesity (39,65,67,68) .…”

Section: Lichen Sclerosus As a Kö Bner Phenomenonmentioning

confidence: 99%

Does lichen sclerosus play a central role in the pathogenesis of human papillomavirus negative vulvar squamous cell carcinoma? The itch-scratch-lichen sclerosus hypothesis

Scurry¹

1999

Int J Gynecol Cancer

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In the past decade, two types of vulvar squamous cell carcinoma (SCC) have been delineated, Human papillomavirus (HPV) positive and negative. Clinicopathologic, virologic, cytomorphometric, and genetic differences support the view that these two types of carcinoma are fundamentally different and that HPV‐negative carcinoma is not simply carcinoma where viral DNA has not been able to be identified. The traditional view of HPV‐negative carcinoma is that it is caused by chronic tissue damage from itching and scratching. However, itching and scratching alone do not explain the close association of carcinoma with lichen sclerosus, nor the absence of such an association with other itchy conditions such as eczema or psoriasis. These observations point to a role for lichen sclerosus in the pathogenesis of vulvar carcinoma. Most observations about the etiology of lichen sclerosus can be grouped into its immunogenetic or genital predisposition, or the Köbner phenomenon. In the itch‐scratch‐lichen sclerosus hypothesis, lichen sclerosus is postulated to occur as a Köbner phenomenon in women with the susceptible immunophenotype who scratch because of genital irritants such as urine, vaginal secretions and smegma, and psychological factors. Lichen sclerosus, itself a very itchy condition, contributes to a vicious cycle of itching and scratching which leads to superimposed lichen simplex chronicus, squamous cell hyperplasia, and ultimately carcinoma. The itch‐scratch‐lichen sclerosus hypothesis reconciles the traditional itch‐scratch hypothesis with the strong clinicopathologic association of lichen sclerosus with carcinoma.

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Section: Lichen Sclerosus As a Kö Bner Phenomenonmentioning

confidence: 99%

Does lichen sclerosus play a central role in the pathogenesis of human papillomavirus negative vulvar squamous cell carcinoma? The itch-scratch-lichen sclerosus hypothesis

Scurry¹

1999

Int J Gynecol Cancer

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“…It has been reported that LSA exhibits an isomorphic phenomenon, with lesions occurring in scars, after trauma, after vulvovaginitis, at the site of brassiere straps, and after sunburn (12)(13)(14)(15)(16)(17). In five children, worsening of the disease could have been related to tight clothing or riding a bicycle (1).…”

Section: Discussionmentioning

confidence: 99%

Lichen Sclerosus et Atrophicus in Children and Young Adults

Helm

Gibson

Muller

1991

Pediatric Dermatology

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We performed a retrospective study of 52 children and young adults (average age 18 yrs) with lichen sclerosus et atrophicus. In 56% of patients the eruption was still present after a follow-up of 7.5 years. Younger patients were most likely to show improvement. The histologic appearance of both groups (patients with persistent lesions and those with resolution of lesions) showed classic features of lichen sclerosus et atrophicus: homogenized collagen with an underlying bandlike lymphocytic infiltrate. Epidermal changes such as atrophy, hyperplasia, and follicular plugging were slightly more prominent in patients with persistent lesions. Menarche, pregnancy, and the presence of extragenital lesions had no effect on the prognosis, but since the condition resolved, on average, during adolescence, unknown developmental factors may be implicated.

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“…leros us a nd vu lvovagin iti ar assor ia t d in children sugges ts Ulat scratchin g could be parU y ca u ative as well as effect of li chen sclerosus in som e pa ti en ts. 24 Grafts of thi gh skin with atLendant vessels and nerves from tll e tlli gh to th vulva in pa ti en ts with vLlI a r li chen scleros us deve. lop lichen sclel'Osus in tlle graIt, w hHe atT'ected vu lvar skin hea ls w hen tran spl anted.…”

Section: Aetiology and Pathogenesis Of Lichen Sclerosusmentioning

confidence: 99%

Vulvar squamous cell carcinoma and lichen sclerosus

Scurry

Vanin

1997

Aust J Dermatology

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There are two clinicopathological types of vulvar squamous cell carcinoma, human papillomavirus (HPV)-positive and HPV-negative, which can be distinguished to some degree on routine histology. Human papillomavirus-positive carcinomas account for one-quarter to one-third of cases, occur in women on average 20 years younger than in HPV-negative, and are associated with multiple lower genital tract neoplasia. Human papillomavirus negative carcinoma is linked to lichen sclerosus. Of all carcinomas, 7-96% show lichen sclerosus in skin adjacent to the carcinoma, the majority being the first presentation of lichen sclerosus, and up to 5% of patients with lichen sclerosus develop carcinoma after long-term follow up. Where lichen sclerosus is associated with malignancy, it is often hyperplastic, may show a subtle form of intraepithelial neoplasia termed 'differentiated vulvar intraepithelial neoplasia', and may lose its pathognomonic oedematous-hyaline layer. The local additional factors causing lichen sclerosus to develop malignancy on the vulva are not known.

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Lichen Sclerosus Et Atrophicus in Young Subjects.*

Cited by 32 publications

References 14 publications

Does lichen sclerosus play a central role in the pathogenesis of human papillomavirus negative vulvar squamous cell carcinoma? The itch-scratch-lichen sclerosus hypothesis

Does lichen sclerosus play a central role in the pathogenesis of human papillomavirus negative vulvar squamous cell carcinoma? The itch-scratch-lichen sclerosus hypothesis

Lichen Sclerosus et Atrophicus in Children and Young Adults

Vulvar squamous cell carcinoma and lichen sclerosus

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