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Clobetasol would …help relieve itching and  inflammation but because it is a strong steroid medication, it is  not designed for long term use. Lichen sclerosus is chronic skin disorder that most often affects genital and perianal areas. Lichen sclerosus (LS) was previously known as lichen sclerosus et atrophicus, and historically was also called kraurosis vulvae.
Lichen sclerosus may follow or co-exist with another skin condition such as lichen simplex, psoriasis, morphoea, vitiligo, candidiasis or erosive lichen planus. It is estimated that around 15% of patients know of a family member that has been affected by lichen sclerosus.
People with lichen sclerosus often have a personal or family history of other autoimmune conditions such as thyroid disease (about 20% of patients), pernicious anaemia, or alopecia areata.
The cause of lichen sclerosus is not fully understood and may include genetic, hormonal, irritant and infectious components.
Lichen sclerosus presents as white crinkled or thickened patches of skin that have a tendency to scar. In women, lichen sclerosus can be localised to one small area or extensively involve the perineum, labia majora, labia minora, fourchette and clitoris.
The skin around the anus (perianal skin) is also be affected by lichen sclerosus in about 50% of affected women.
In men, lichen sclerosus usually affects the tip of the penis (glans), which becomes firm and white (also called balanitis xerotica perstans).
Lichen sclerosus may also affect non-genital areas and does so in 10% of patients with vulval disease.
In females, vulval lichen sclerosus is associated with an increased risk of vulval cancer or anal cancer (squamous cell carcinoma, SCC). Penile lichen sclerosus may rarely predispose to penile intraepithelial neoplasia, penile cancer or anal cancer. During follow-up, a specialist may decide to perform another biopsy to evaluate areas of concern or explain poor response to treatment. Patients are advised to become familiar with the location and appearance of their lichen sclerosus. Topical steroids (especially clobetasol propionate ointment) are the main treatment for lichen sclerosus.
In most cases, occasional application of topical steroid is all that is required to control lichen sclerosus long term. Topical calcineurin inhibitors tacrolimus ointment and pimecrolimus cream can be effective in lichen sclerosus on their own or in addition to topical steroids, but may be difficult to use because they tend to cause burning (at least for the first few days).
Calcipotriol cream, more often used for psoriasis, can soften lichen sclerosus and may reduce or reverse skin thinning caused by topical steroids (unproven).


Topical retinoid cream is not well tolerated on genital skin but may be applied to other sites affected by lichen sclerosus. When very lichen sclerosus is very severe, acute, and not responding to topical therapy, systemic steroids may be prescribed for a few weeks. In females with lichen sclerosus, a narrowed vaginal opening may need gentle stretching using vaginal dilators.
Surgical release of vulval and vaginal adhesions and scarring from vulval lichen sclerosus may occasionally be performed to reduce urination difficulties and allow intercourse. Unfortunately, lichen sclerosus sometimes closes up the vaginal opening again after surgery has initially appeared successful.
There is no known cure for lichen sclerosus, although most people are substantially improved and quite comfortable with treatment.
Long-term specialist follow-up is recommended to assess the disease, optimise treatment and ensure early diagnosis of cancer. New Surgical Approach to Lichen Sclerosus of the Vulva: The Role of Adipose-Derived Mesenchymal Cells and Platelet-Rich Plasma in Tissue Regeneration. British Association of Dermatologists' guidelines for the management of lichen sclerosus 2010, SM Neill, FM Lewis, FM Tatnall, NH Cox, BJD, Vol.
Treatment for this condition might be unnecessary as the condition often improves without any professional medical care.
Creams and ointments with a corticosteroid base are often prescribed to patients of Lichen sclerosus. According to a recent study, prolonged treatment with antibiotic medications has been found to yield effective results in all affected individuals.
In uncircumcised men affected by LS on the foreskin, circumcision is a common treatment option. This is because lichen sclerosus causes adhesions and scarring: sometimes the clitoris is buried (phimosis), the labia minora (inner lips) can shrink and the entrance to the vagina tightens (introital stenosis). Extragenital lichen sclerosus is described as looking like cigarette paper, with a wrinkled surface and waxy thickened feel. A skin biopsy is frequently recommended to confirm the diagnosis, as there are characteristic histopathological findings in lichen sclerosus. The doctor should reassess the treated area after a few weeks, as the response to treatment is quite variable. These are usually effective, but have important side effects, so are not used long term for lichen sclerosus. Patients may not require treatment if the genital region is unaffected, and in case of absence of symptoms. As per recent researches, however, such drugs are not as effective in curing the condition as the treatment options mentioned above.


In case you have already been diagnosed with the condition, visit your physician after every 6-12 months to ensure the absence of any side effects of treatment or any abnormal changes in your skin appearance.
Six percent of men and women with extragenital lichen sclerosus do not have genital lichen sclerosus. It may affect up to 5% of patients with vulval lichen sclerosus and can be quite aggressive. One or more biopsies may be taken to rule out other possible explanations for the skin condition such as dermatitis, lichen planus, vulval intraepithelial neoplasia or vulval cancer. Many clinicians use photographs to monitor the activity of lichen sclerosus, and may provide their patients with copies, so that they are clear where to apply topical treatment.
It may need to be continued on a regular basis (perhaps once or twice a week) to prevent the lichen sclerosus recurring or to control on-going symptoms.
Read and know all about the condition, including its causes, symptoms, diagnosis and treatment options.
However, symptomatic cases the disorder might result in other complications if left without treatment. Extracellular matrix protein-1 (ECM-1) antibodies have been detected in 60–80% of women with vulval lichen sclerosus. Lichen sclerosus may also give rise to differentiated or usual-type (HPV-associated) vulval intraepithelial neoplasia (VIN). Over-use of topical corticosteroids can result in skin thinning, red skin and discomfort; this is uncommon when applied accurately to lichen sclerosus. In general, after initial more generous treatment, one 30-g tube is expected to last about 6 to 12 months. Antibodies to other unknown proteins may account for other cases, explaining differing presentations of lichen sclerosus and response to treatment. In case treatment is necessary, a physician may recommend medical options that may help restore normal appearance of the skin as well as reduce the risk of scarring.
Topical steroids, such as Clobetasol propionate, may alleviate the discomforting symptoms and prevent risk of scarring. Treatment also aims at reducing itchiness, which is one of the major issues associated with this disease.



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