Lichen Sclerosus—Presentation, Diagnosis and Management

Kirtschig, Gudula

doi:10.3238/arztebl.2016.0337

Cited by 100 publications

(169 citation statements)

References 46 publications

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“…The differential diagnosis of guttate leukoderma includes vitiligo, achromic pityriasis lichenoides chronica, confetti macules of tuberous sclerosus, guttate morphea, amyloidosis cutis dyschromica, chemical leukoderma, and idiopathic guttate hypomelanosis. 3,4 Vitiligoid variant of LS, as seen and confirmed via histology in our patient, is considered to be a superficial variant of LS that clinically mimics vitiligo. 5 While LS is frequently pruritic and even sometimes painful, vitiligoid LS is usually less symptomatic or even asymptomatic.…”

Section: Discussionsupporting

confidence: 60%

Guttate leukoderma in a 7‐year‐old girl

Shah

Esaa

Scott

et al. 2019

Pediatric Dermatology

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Section: Discussionsupporting

confidence: 60%

Guttate leukoderma in a 7‐year‐old girl

Shah

Esaa

Scott

et al. 2019

Pediatric Dermatology

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“…Our study also proved that the older‐onset patients more frequently developed edema in the area of LS lesions, the reason for which is probably that the skin is more lax in older women. Interestingly, we only observed one patient with subsequent SCC, while reports from other countries found a slightly higher incidence of SCC (2–5%) . This may be because our enrolled patients were younger.…”

Section: Discussioncontrasting

confidence: 60%

Vulvar lichen sclerosus: A single‐center retrospective study in China

Yang

Wen

Chang

2018

The Journal of Dermatology

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Vulvar lichen sclerosus (VLS) is an uncommon, chronic inflammatory skin disease lacking clinical data of large sample size in China. This study was intended to provide missing data on this condition through investigating the clinical characteristics of Chinese VLS patients. The medical records of 129 VLS patients from our vulvar outpatient clinic were analyzed with SPSS version 18.0 software. The age of onset followed a normal distribution, with the peak at 25-30 years. Of all cases, the incidence rate during the postmenopausal period was 14.0% with an average duration of 9.22 years. The most frequently involved site was the bilateral labia minora (71.3%). Itching was the principal symptom (94.6%); meanwhile, patients with severe itching more commonly experienced longer duration, flaring at night, hyperkeratotic lesions or rashes on the posterior commissure than those with mild to moderate itching (P < 0.05). Furthermore, 60% of the enrolled patients suffered from sexual dysfunction. The major sign was pallor (92.2%), followed by hyperkeratosis (55.0%) and atrophy (40.3%). The patients with atrophy had a significantly longer duration of the disease, and the older patients presented more frequently with edema in the area of lesions (both P < 0.05). Of our patients, 9.3% suffered concomitantly from autoimmune diseases, mostly thyroid with one case being complicated by vulvar squamous cell carcinoma (SCC). In our study, the severity of pruritus was partly related to clinical manifestations. Moreover, Chinese patients could have developed VLS mostly in the reproductive period, with less complications of autoimmune diseases or SCC.

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“…Lichen sclerosus (LS) is a chronic inflammatory skin disease predominantly affecting the anogenital area in both sexes. Symptoms range from none to pruritus and pain, with a possible progression to scars and anatomic disfigurement and 5% increased risk of squamous cell carcinoma (SCC) in the genital area . It is more common in women than in men, with a ratio between 10 : 1 and 6 : 1, and is estimated to affect between 1/300 and 1/1000 in both sexes.…”

Section: Introductionmentioning

confidence: 99%

The possible role of human papillomavirus infection in the development of lichen sclerosus

Hald

Blaakær

2017

Int J Dermatology

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Lichen sclerosus (LS) is a chronic inflammatory skin disease of unknown origin predominantly affecting the anogenital area that causes pruritus and pain and is associated with an increased risk of malignancy. In some cases, LS vanishes after application of imiquimod, raising the question whether human papillomavirus (HPV) may have an etiopathogenic role in anogenital LS. The databases MEDLINE and Embase were systematically searched using the PRISMA guidelines. Twenty-seven papers were included that reported the prevalence of HPV in LS and in LS associated with neoplasia. HPV was identified in 0-80% (median 22%) of all LS cases. The prevalence of HPV was higher among male patients with LS (median 29%) than among female patients (median 8%). HPV16 was the most prevalent genotype, but the distribution of genotypes indicates that even low-risk HPV can cause LS. The diverging detection rates are probably due to small sample sizes in the reviewed papers and different detection methods. Factors possibly underestimating the prevalence of HPV are a selective search for high-risk HPV, DNA destruction in fixed tissue, focally residing HPV, and possibly a clearing of HPV before the time of biopsy. Seventy-five percent of sexually active people acquire HPV during their lifetime, thus HPV alone is not a cause of LS. Genetic and immunological host factors and viral factors other than type are likely to contribute. Future studies should include patients with a short duration of symptoms, and biopsies should be multiple and fresh.

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Lichen Sclerosus—Presentation, Diagnosis and Management

Cited by 100 publications

References 46 publications

Guttate leukoderma in a 7‐year‐old girl

Guttate leukoderma in a 7‐year‐old girl

Vulvar lichen sclerosus: A single‐center retrospective study in China

The possible role of human papillomavirus infection in the development of lichen sclerosus

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