Lichen Sclerosis

Overview
  • Lichen Sclerosis is a chronic inflammatory disorder, typically affecting women, that manifests as white atrophic pruritic plaques with a prediliction for the anogenital skin.
Morphology
  • Lesions of lichen sclerosis initially begin with an inflammatory phase that manifests as a flat-topped white plaque surrounded by a rim of erythema. Over time, the lesions become atrophic, shiny, and sclerotic, in some cases contracting and obliterating surface anatomical features. As mentioned, the lesions have a predilection for the anogenital region in women, frequently encircling the vagina and anus in an hour-glass shape, causing stenosis of the urethra, and obliterating the labia minora.
Clinical Consequences
  • The lesions of lichen sclerosis are typically pruritic. Their potential to deform affected tissue may yield dyspareunia or urethral stensosis. Finally, a small percentage of lesions may harbor Skin Squamous Cell Carcinoma, especially Vulval SCC.