Lichen Sclerosus et Atrophicus

Abstract

Lichen sclerosus (LS) et atrophicus et atrophicus, commonly referred to as LS, is a relatively uncommon chronic inflammatory condition that typically affects the skin of the vulvar and perianal regions but can involve extragenital areas. This review will focus primarily on vulvar LS. Although LS can affect men and prepubescent patients, LS has a much higher incidence in women over the age of 30 years. When correctly diagnosed and treated in its earlier stages, LS, although still chronic, is manageable with the appropriate protocol. When left untreated or poorly managed, LS can progress to its later “atrophic” stages and cause severe lichenification, atrophy, and destructive scarring, resulting in the loss of normal anatomic landmarks and function of the genitals. In addition, both men and women with genital LS have an increased risk of developing squamous cell carcinoma in the affected skin. In women, 65% of genital squamous cell carcinomas arise from a preexisting lesion from LS. This can negatively affect a patient's sleep and physical, mental, and social/emotional health. Increased awareness of the presentation and symptoms, in both providers and patients, of LS et atrophicus encourages earlier treatment and management while preventing long-term, irreversible physical, mental, and emotional damage.