Progressive Extragenital Lichen Sclerosus Successfully Treated With Narrowband UV-B Phototherapy

Lichen sclerosus (LS) is a chronic, inflammatory, mucocutaneous disorder of genital and extragenital skin. LS is a debilitating disease, causing itch, pain, dysuria and restriction of micturition, dyspareunia, and significant sexual dysfunction in women and men. Many findings obtained in recent years point more and more towards an autoimmune-induced disease in genetically predisposed patients and further away from an important impact of hormonal factors. Preceding infections may play a provocative part. The role for Borrelia is still controversial. Trauma and an occlusive moist environment may act as precipitating factors. Potent and ultrapotent topical corticosteroids still head the therapeutic armamentarium. Topical calcineurin inhibitors are discussed as alternatives in the treatment of LS in patients who have failed therapy with ultrapotent corticosteroids, or who have a contraindication for the use of corticosteroids. Topical and systemic retinoids may be useful in selected cases. Phototherapy for extragenital LS and photodynamic therapy for genital LS may be therapeutic options in rare cases refractory to the already mentioned treatment. Surgery is restricted to scarring processes leading to functional impairment. In men, circumcision is effective in the majority of cases, but recurrences are well described. Anogenital LS is associated with an increased risk for squamous cell carcinoma of the vulva or penis. This review updates the epidemiology, clinical presentation, histopathology, pathogenesis, and management of LS of the female and male genitals and extragenital LS in adults and children.

show abstract

“…An individual case of extragenital LS treated successfully with narrow-band UVB has been reported [138]. …”

Section: Treatmentmentioning

confidence: 99%

Diagnosis and Treatment of Lichen Sclerosus

2012

View full text Add to dashboard Cite

show abstract

“…Most patients with extragenital LS are initially treated with potent topical corticosteroids with variable results. Other reported treatments include topical retinoids, topical tacrolimus or pimecrolimus, oral steroids, cyclosporine, phototherapy, laser therapy, and surgical excision 6–8 . Patients with severe and refractory disease may be treated with high‐dose corticosteroids combined with low‐dose methotrexate therapy 9 …”

Section: Discussionmentioning

confidence: 99%

Hypopigmented papules on the upper trunk and forearm of a young man

2011

View full text Add to dashboard Cite

show abstract

“…Le diagnostic repose sur l'histologie cutanée qui révèle une atrophie de l'épithélium malpighien avec horizontalisation de la basale, une hyperkératose folliculaire, et surtout la pré-sence d'une bande sous épithéliale faite de collagène fibreux ou oedémateux au niveau du derme superficiel, dépourvue de fibres élastiques à la coloration à l'orcéïne [7]. Le traitement du LSA extra-génital n'est pas codifié et fait recours à plusieurs thérapeutiques : dermocorticoïdes de classe très forte, antipaludéens de synthèse, tacrolimus, pimécrolimus, rétinoïdes, avec des résultats satisfaisants sous calcipotriol et photothérapie UVB [8,9]. …”

Section: Commentairesunclassified