Lichen sclerosus - Knowledge

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scleroderma and LS were closely related, which continues to this day. In 1901, pediatric LS was described. From 1913 to present, the concept that scleroderma is not closely related to LS also was formed. In 1920, Taussig established vulvectomy as the treatment of choice for kraurosis vulvae, a premalignant condition. In 1927, Kyrle defined LS ("white spot disease") as an entity sui generis. In 1928, Stühmer described balanitis xerotica obliterans as a postcircumcision phenomenon. In 1936, retinoids (vitamin A) were used to treat LS. In 1945, testosterone was used in genital LS. In 1961, the use of corticosteroids started. Jeffcoate presented an argument against vulvectomy for simple LS. In 1971, progesterone was used in LS. Wallace defined clinical factors and the epidemiology of LS. In 1976, Friedrich defined LS as a dystrophic and not an atrophic condition, and "et atrophicus" was dropped. The

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women throughout six years, cancer occurred for 4.7% of patients who were only "partially compliant" with corticosteroid treatment, while it occurred in 0% of cases where they were "fully compliant". In a second study, of 129 patients, cancer occurred in 11% of patients, none of whom were fully compliant with corticosteroid treatment. Both those studies, however, also said that a corticosteroid as powerful as clobetasol is not necessary in most cases. In a prospective study of 83 patients, throughout 20 years, eight developed cancer. Six already had cancer at presentation and had not had treatment, while the other two were not taking corticosteroids often enough. In all three studies, every single cancer case observed occurred in patients who were not taking corticosteroids as often as the study recommended.

48: 333: 137: 57: 125: 108:) when it affects the penis. Lichen sclerosus is not contagious. There is a well-documented increase of skin cancer risk in LS, potentially improvable with treatment. LS in adult age women is normally incurable, although treatment can lessen its effects, and it often gets progressively worse if not treated properly. Most males with mild or intermediate disease, restricted to 439:(calcineurin inhibitor) all are effective therapies in treating genital lichen sclerosus. However, randomized-controlled trials are needed to further identify the optimal potency and regimen of topical corticosteroids, and assess the duration of remission and/or the prevention of flares patients experience with these topical therapies. 411:

There is no definitive cure for LS. Behavior change is part of treatment. The patient should minimize or, preferably, stop scratching LS-affected skin. Any scratching, stress or damage to the skin can worsen the disease. Scratching has been theorized to increase cancer risks. Furthermore, the patient

483:. Lichen sclerosus is associated with from 3 to 7% of all cases of vulvar squamous cell carcinoma. In women, it has been reported that 33.6 times higher vulvar cancer risk is associated with LS. A study in men noted that: "the reported incidence of penile carcinoma in patients with BXO is 2.6–5.8%". 189:

According to the US National Vulvodynia Association, which also supports women with lichen sclerosus, vulvo-vaginal conditions can cause feelings of isolation, hopelessness, low self-image, and much more. Some women are unable to continue working or have sexual relations, and may be limited in other

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Lewis, F.M.; Tatnall, F.M.; Velangi, S.S.; Bunker, C.B.; Kumar, A.; Brackenbury, F.; Mohd Mustapa, M.F.; Exton, L.S.; McHenry, P.M.; Leslie, T.A.; Wakelin, S.; Hunasehally, R.Y.P.; Cork, M.; Johnston, G.A.; Chiang, N.; Worsnop, F.S.; Buckley, D.; Petrof, G.; Salin, A.; Callachand, N.; Saunders, C.;

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applied topically to the LS-affected skin are the first-line treatment for lichen sclerosus in both women and men, with strong evidence showing that they are "safe and effective" when appropriately applied, even over long courses of treatment, rarely causing serious adverse effects. They improve or

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Continuous, abundant usage of emollients topically applied to the LS-affected skin is recommended to improve symptoms. They can supplement, but not replace, corticosteroid therapy. They can be used much more frequently than corticosteroids due to the extreme rarity of serious adverse effects. With

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Continuous use of appropriate doses of topical corticosteroids is required to ensure symptoms remain relieved over the patient's life time. If continuously used, corticosteroids have been suggested to minimize the risk of cancer in various studies. In a prospective longitudinal cohort study of 507

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In males, it has been reported that circumcision can have positive effects, but does not necessarily prevent further flare-ups of the disease and does not protect against the possibility of cancer. Circumcision does not prevent or cure LS. In fact, "balanitis xerotica obliterans" in men was first

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classification system established that "kraurosis" and "leukoplakia" were no longer to be used. In 1980, fluorinated and superpotent steroids were first used to treat LS. In 1981, studies into HLA serotypes and LS were published. In 1984, etretinate and acetretin were used in LS. In 1987, LS was

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Balanitis xerotica obliterans, lichen sclerosus et atrophicus, Lichen sclerosis et atrophicus, lichen plan atrophique, lichen plan scléreux, Kartenblattförmige Sklerodermie, Weissflecken Dermatose, lichen albus, lichen planus sclerosus et atrophicus, dermatitis lichenoides chronica atrophicans,

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Rotondo, J.C.; Borghi, A.; Selvatici, R.; Magri, E.; Bianchini, E.; Montinari, E.; Corazza, M.; Virgili, A.; Tognon, M.; Martini, F. (2016). "Hypermethylation-Induced Inactivation of the IRF6 Gene as a Possible Early Event in Progression of Vulvar Squamous Cell Carcinoma Associated With Lichen

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In 1875, Weir reported what was possible vulvar or oral LS was "ichthyosis." In 1885, Breisky described kraurosis vulvae. In 1887, Hallopeau described a series of extragenital cases of LS. In 1892, Darier formally described the classic histopathology of LS. In 1900, the concept was formed that

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genital LS, appropriate lubrication should always be used before and during sex in order to avoid pain and the worsening the disease. Some oils, such as olive oil and coconut oil, can be used to accomplish both the emollient and sexual lubrication function.

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Casabona, Francesco; Gambelli, Ilaria; Casabona, Federica; Santi, Pierluigi; Santori, Gregorio; Baldelli, Ilaria (2017). "Autologous platelet-rich plasma (PRP) in chronic penile lichen sclerosus: the impact on tissue repair and patient quality of life".

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There is a bimodal age distribution in the incidence of LS in women. It occurs in females with an average age of diagnosis of 7.6 years in girls and 60 years old in women. The average age of diagnosis in boys is from 9 to 11 years old.

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Chi, C.C.; Kirtschig, G.; Baldo, M.; Lewis, F.; Wang, S.H.; Wojnarowska, F. (Aug 2012). "Systematic review and meta-analysis of randomized controlled trials on topical interventions for genital lichen sclerosus".

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Dahlman-Ghozlan, Kristina; Hedbla, Mari-Anne; von Krogh, Geo (1999). "Penile lichen sclerosus et atrophicus treated with clobetasol dipropionate 0.05% cream: A retrospective clinical and histopathologic study".

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Li, Y.; Xiao, Y.; Wang, H.; Li, H.; Luo, X. (Aug 2013). "Low-concentration topical tacrolimus for the treatment of anogenital lichen sclerosus in childhood: maintenance treatment to reduce recurrence".

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Scurry, J. (March 1999). "Does lichen sclerosus play a central role in the pathogenesis of human papillomavirus negative vulvar squamous cell carcinoma? The itch-scratch-lichen sclerosus hypothesis".

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In males, the disease may take the form of whitish patches on the foreskin and its narrowing (preputial stenosis), forming an "indurated ring", which can make retraction more difficult or impossible (

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Lichen sclerosus is associated with a higher risk of cancer. Skin that has been scarred as a result of lichen sclerosus is more likely to develop skin cancer. Women with lichen sclerosus may develop

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such as tacrolimus can have an effect similar to corticosteroids, but its effects on cancer risks with LS are not conclusively known. Based on limited evidence, a 2011 Cochrane review concluded that

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Sherman, V.; McPherson, T.; Baldo, M.; Salim, A.; Gao, X.H.; Wojnarowska, F. (Sep 2010). "The high rate of familial lichen sclerosus suggests a genetic contribution: an observational cohort study".

100:) is a chronic, inflammatory skin disease, of unknown cause, which can affect any body part of any person, but has a strong preference for the genitals (penis, vulva), and is also known as 148:(in genital LS), easier bruising, cracking, tearing and peeling, as well as hyperkeratosis, are common symptoms in both men and women. In women, the condition most commonly occurs on the 3272: 1141:

Drut, R.M.; Gomez, M.A.; Drut, R.; Lojo, M.M. (1998). "Human papillomavirus is present in some cases of childhood penile lichen sclerosus: an in situ hybridization and SP-PCR study".

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Pietrzak, Peter; Hadway, Paul; Corbishley, Cathy M.; Watkin, Nicholas A. (2006). "Is the association between balanitis xerotica obliterans and penile carcinoma underestimated?".

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was reported to be effective in one study, producing large improvements in the patients' quality of life, with an average IGA improvement of 2.04 and DLQI improvement of 7.73.

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Barbagli, G.; Palminteri, E.; Mirri, F.; Guazzoni, G.; Turini, D.; Lazzeri, M. (2006). "Penile carcinoma in patients with genital lichen sclerosus: a multicenter survey".

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Dalziel, K.L.; Millard, P.R.; Wojnarowska, F. (1991). "The treatment of vulval lichen sclerosus with a very potent topical steroid (clobetasol Propionate 0.05%) cream".

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Powell, J.; Robson, A.; Cranston, D.; Wojnarowska, F.; Turner, R. (2001). "High incidence of lichen sclerosus in patients with squamous cell carcinoma of the penis".

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Kizer, William S.; Prarie, Troy; Morey, Allen F. (January 2003). "Balanitis Xerotica Obliterans: Epidemiologic Distribution in an Equal Access Health Care System".

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state (prepubertal and postmenopausal women), hormonal influences have been postulated. To date though, very little evidence has been found to support that theory.

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Although it is not clear what causes LS, several theories have been postulated. Lichen sclerosus is not contagious and cannot be caught from another person.

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Rotondo, J.C.; Borghi, A.; Selvatici, R.; Mazzoni, E.; Bononi, I.; Corazza, M.; Kussini, J.; Montinari, E.; Gafà, R.; Tognon, M.; Martini, F. (2018).

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Poulsen, H.; Junge, J.; Vyberg, M.; Horn, T.; Lundvall, F. (2003). "Small vulvar squamous cell carcinomas and adjacent tissues. A morphologic study".

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Lichen sclerosus may have a genetic component. A high correlation of lichen sclerosus has been reported between twins and between family members.

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Meyrick Thomas, R.H.; Ridley, C.M.; McGibbon, D.H.; Black, M.M. (1988). "Lichen sclerosus et atrophicus and autoimmunity—a study of 350 women".

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Gutierrez-Ontalvilla, Patricia (2019). "The Female Sexual Function Index to assess patients with moderate to severe vulvar lichen sclerosus".

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Some findings suggest that LS can be initiated through scarring or radiation, although those findings were sporadic and very uncommon.

163:). In addition there can be lesions, white patches or reddening on the glans. In contrast to women, anal involvement is less frequent. 378:

It has been noted that clinical diagnosis of BXO can be "almost unmistakable," though there are other dermatologic conditions such as

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Distress due to the discomfort and pain of lichen sclerosus is normal, as are concerns with self-esteem and sex. Counseling can help.

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Smith, S.D.; Fischer, G. (2009). "Childhood onset vulvar lichen sclerosus does not resolve at puberty: a prospective case series".

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Eisendle, K.; Grabner, T.G.; Kutzner, H. (2008). "Possible Role of Borrelia burgdorferi Sensu Lato Infection in Lichen Sclerosus".

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Yashar, S.; Han, K.F.; Haley, J.C. (2004). "Lichen sclerosus-lichen planus overlap in a patient with hepatitis C virus infection".

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or other problems, and not correctly diagnosed until the patient is referred to a specialist after the problem does not clear up.

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Meyrick Thomas, R.H.; Kennedy, C.T. (March 1986). "The development of lichen sclerosus et atrophicus in monozygotic twin girls".

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Garzon, Maria C.; Paller, Amy S. (1999). "Ultrapotent Topical Corticosteroid Treatment of Childhood Genital Lichen Sclerosus".

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has been used as a safe and effective corticosteroid for mild and moderate cases. For severe cases, it has been theorized that

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physical activities. Depression, anxiety, and even anger are all normal responses to the ongoing pain LS sufferers experience.

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should wear comfortable clothes and avoid tight clothing, as it is a major factor in the severity of symptoms in some cases.

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Renaud-Vilmer, Catherine; Cavelier-Balloy, Bénédicte; Porcher, Raphaël; Dubertret, Louis (2004). "Vulvar Lichen Sclerosus".

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The disease can last for a considerably long time. Occasionally, "spontaneous cure" may occur, particularly in young girls.

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Lichen sclerosus on an 82-year-old woman, showing an ivory white coloring in the vulva, and also stretching downward to the

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On the non-genital skin, the disease may manifest as porcelain-white spots with small visible plugs inside the orifices of

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Chi, Ching-Chi; Kirtschig, Gudula; Baldo, Maha; Brackenbury, Fabia; Lewis, Fiona; Wojnarowska, Fenella (2011-12-07).

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Cox, N.H.; Mitchell, J.N.; Morley, W.N. (Dec 1986). "Lichen sclerosus et atrophicus in non-identical female twins".

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van de Nieuwenhof, HP; van der Avoort, IA; de Hullu, JA (2008). "Review of squamous premalignant vulvar lesions".

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Pass, C.J. (1984). "An unusual variant of lichen sclerosus et atrophicus: delayed appearance in a surgical scar".

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The disease often goes undiagnosed for several years, because it is sometimes not recognized, and misdiagnosed as

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is a process in which the body fails to recognize itself and therefore attacks its own cells and tissue. Specific

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suppress all symptoms for some time, with high variance across patients, until it is required to use them again.

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Micrograph of extragenital lichen sclerosus: epidermal atrophy, follicular plugging and basal vacuolization, and

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treatment is safe and effective, and improves symptoms over the long term, but it does not lower cancer risks.

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Nasca, M.R.; Innocenzi, D.; Micali, G. (1999). "Penile cancer among patients with genital lichen sclerosus".

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Birenbaum, D.L.; Young, R.C. (2007). "High prevalence of thyroid disease in patients with lichen sclerosus".

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activity in dermis are histological findings associated with LS. The biopsies are also checked for signs of

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Yates, V.M.; King, C.M.; Dave, V.K. (1985). "Lichen sclerosus et atrophicus following radiation therapy".

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Milligan, A.; Graham-Brown, R.A.; Burns, D.A. (1988). "Lichen sclerosus et atrophicus following sunburn".

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Hallopeau, H. (1887). "Du lichen plan et particulièrement de sa forme atrophique: lichen plan scléreux".

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Halonen, Pia; Jakobsson, Maija; Heikinheimo, Oskari; Riska, Annika; Gissler, Mika; Pukkala, Eero (2017).

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https://web.archive.org/web/20070927210529/http://dermis.multimedica.de/dermisroot/de/34088/diagnose.htm

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Windahl, T. (2009). "Is carbon dioxide laser treatment of lichen sclerosus effective in the long run?".

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Shelley, W. B.; Shelley, E. D.; Amurao, C. V. (2006). "Treatment of lichen sclerosus with antibiotics".

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Bradford, J.; Fischer, G. (2010). "Long-term management of vulval lichen sclerosus in adult women".

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Neill, S.M.; Tatnall, F.M.; Cox, N.H. (2002). "Guidelines for the management of lichen sclerosus".

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Depasquale, I.; Park, A.J.; Bracka, A. (2000). "The treatment of balanitis xerotica obliterans".

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Jędrowiak, Anna; Kobusiewicz, Aleksandra; Trznadel-Grodzka, Ewa; Kaszuba, Andrzej (2018).

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might be safer and more effective than clobetasol. Recent studies have shown that topical

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Meffert, Jeffrey J; Davis, Brian M; Grimwood, Ronald E (March 1995). "Lichen sclerosus".

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A biopsy of the affected skin can be done to confirm a diagnosis. When a biopsy is done,

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Yesudian, P.D.; Sugunendran, H.; Bates, C.M.; O'Mahony, C. (2005). "Lichen sclerosus".

784:. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Archived from 758: 424: 272:

pathogens have been implicated in the etiology of LS. A disease that is similar to LS,

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List of cutaneous conditions associated with increased risk of nonmelanoma skin cancer

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https://web.archive.org/web/20071008130921/http://dermnetnz.org/immune/ls-imgs.html

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LS can occur without symptoms. White patches on the LS body area, itching, pain,

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reported by Stühmer in 1928. as a condition affecting a set of circumcised men.

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Medscape Reference Author: Jeffrey Meffert, MD; Chief Editor: Dirk M Elston, MD

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Henquet, C.J. (August 2011). "Anogenital malignancies and pre-malignancies".

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List of human leukocyte antigen alleles associated with cutaneous conditions

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Laymon, CW (1951). "Lichen sclerosus et atrophicus and related disorders".

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have been found in LS sufferers. Furthermore, there seems to be a higher

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Gulin, Sandra Jerkovic; Lundin, Filippa; Seifert, Oliver (2023-09-11).

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Smith, Yolanda R.; Haefner, Hope K. (2004). "Vulvar Lichen Sclerosus".

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Australian and New Zealand Journal of Obstetrics and Gynaecology

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Regauer, S (2005). "Immune dysregulation in lichen sclerosus".

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European Dermatology Forum Guideline on Lichen Sclerosus (2014)

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Journal of the European Academy of Dermatology and Venereology

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Journal of the European Academy of Dermatology and Venereology

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Lichen sclerosus et atrophicus was first described in 1887 by

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with ivory-white elevations that may be flat and glistening.

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of lichen sclerosus showing the characteristic subepithelial

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Neill, S.M.; Lewis, F.M.; Tatnall, F.M.; Cox, N.H. (2010).

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International Society for the Study of Vulvovaginal Disease

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Since LS in females is primarily found in women with a low

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http://www.dermlectures.com/LecturesWMV.cfm?lectureID=88

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Lee, Andrew; Bradford, Jennifer; Fischer, Gayle (2015).

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Fruchter, R.; Melnick, L.; Pomeranz, M.K. (2017-03-27).

775: 116:, can be cured by either medical or surgical treatment. 2155:"Long-term Management of Adult Vulvar Lichen Sclerosus" 1619:

Todd, P.; Halpern, S.; Kirby, J.; Pembroke, A. (1994).

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In men, the most common age of incidence is 21 to 30.

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on the surface. Thinning of the skin may also occur.

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Cutaneous keratosis, ulcer, atrophy, and necrobiosis

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NIAMS – Questions and Answers About Lichen Sclerosus

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Palisaded neutrophilic and granulomatous dermatitis

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Andrews' Diseases of the Skin: clinical Dermatology

213:. There is evidence that LS can be associated with 201:Several risk factors have been proposed, including 3762:Lupus erythematosus–lichen planus overlap syndrome 2934: 2669: 2152: 1669: 1447: 2771: 1815: 1813: 1140: 954: 506:International Society for Study of Vulvar Disease 4014: 3032: 2353: 2252: 2195: 2065: 1870: 1720: 2146: 1978: 1876: 1612: 1034: 140:Balanitis xerotica obliterans. 70 year old man. 3810:Morphea–lichen sclerosus et atrophicus overlap 3091:Friedrich Jr., EG (1976). "Lichen sclerosus". 2990:Journal of the American Academy of Dermatology 2559:Journal of the American Academy of Dermatology 2413:Scandinavian Journal of Urology and Nephrology 2033:Journal of Pediatric and Adolescent Gynecology 1810: 1776:Journal of the American Academy of Dermatology 1579: 1577: 1508:Journal of the American Academy of Dermatology 1384:- "Figures - available via license: CC BY 4.0" 1183: 884: 629:Journal of the American Academy of Dermatology 572:James, William D.; Berger, Timothy G. (2006). 16:Itchy skin rash usually affecting the genitals 3273: 3090: 3084: 2204:"Diagnosis and Treatment of Lichen Sclerosus" 2202:Fistarol, Susanna K.; Itin, Peter H. (2012). 1586:International Journal of Gynecological Cancer 1315: 3078:Annales de Dermatologie et de Syphiligraphie 2849: 2722: 2513: 2258: 2201: 2029: 1729: 1621:"Lichen sclerosus and the Kobner phenomenon" 1090:International Journal of Women's Dermatology 2404: 2102:The Cochrane Database of Systematic Reviews 2066:Maassen, M.S.; van Doorn, H.C. (2012). "". 1574: 1404: 878: 673:AMA Archives of Dermatology and Syphilology 3280: 3266: 3069: 1498: 622: 620: 618: 55: 46: 19:"BXO" redirects here. For other uses, see 3374:Seborrheic keratosis with squamous atypia 3127:NIAMS – Fast Facts About Lichen Sclerosus 3075: 3026: 3009: 2909: 2754: 2705: 2687: 2628: 2328: 2303: 2235: 2170: 2129: 1837: 1636: 1557: 1368: 1282: 1117: 800: 524:(ISSVD), officially proclaiming the name 3615:Interstitial granulomatous drug reaction 3586:Annular elastolytic giant-cell granuloma 3408:Confluent and reticulated papillomatosis 3391:Keratosis punctata of the palmar creases 2983: 2585: 2261:American Journal of Clinical Dermatology 2208:American Journal of Clinical Dermatology 1220: 843: 331: 135: 123: 3460:Multiple minute digitate hyperkeratosis 3445:Hyperkeratosis of the nipple and areola 2812: 2780:Critical Reviews in Oncology/Hematology 2550: 2410: 2068:Nederlands Tijdschrift voor Geneeskunde 1309: 1177: 849: 809:International Journal of STD & AIDS 664: 615: 181: 4015: 3317:Acrokeratosis paraneoplastica of Bazex 1583: 1255: 1134: 670: 565: 3907:Atrophia maculosa varioliformis cutis 3611:Interstitial granulomatous dermatitis 3261: 2894:"Lichen sclerosus and risk of cancer" 2091: 2089: 1625:Clinical and Experimental Dermatology 1291:Clinical and Experimental Dermatology 1155:10.1046/j.1525-1470.1998.1998015085.x 319: 244:of other autoimmune diseases such as 119: 3435:Hyperkeratosis lenticularis perstans 3093:The Journal of Reproductive Medicine 2676:European Journal of Medical Research 2465:International Urology and Nephrology 1413:International Journal of Dermatology 1387: 1261: 1086:"Lichenoid vulvar disease: A review" 887:The Journal of Reproductive Medicine 685:10.1001/archderm.1951.01570110090013 3887:Acrodermatitis chronica atrophicans 778:"Fast Facts About Lichen Sclerosus" 454: 274:acrodermatitis chronica atrophicans 13: 3989:Poikiloderma vasculare atrophicans 3882:Atrophoderma of Pasini and Pierini 3820:Atrophoderma of Pasini and Pierini 2606:10.1034/j.1600-0463.2003.1110901.x 2086: 1690:10.1111/j.1365-2133.1991.tb00626.x 1638:10.1111/j.1365-2230.1994.tb01183.x 1055:10.1111/j.1365-2133.1988.tb01748.x 969:10.1111/j.1365-2133.1986.tb06659.x 957:The British Journal of Dermatology 926:10.1111/j.1365-2133.1986.tb02831.x 914:The British Journal of Dermatology 576:. Saunders Elsevier. p. 227. 193: 14: 4039: 3930:Reactive perforating collagenosis 3564:Granuloma annulare in HIV disease 3115: 714:. National Vulvodynia Association 706:National Vulvodynia Association. 590: 406: 3379:Reticulated seborrheic keratosis 3047:10.1097/00007611-200301000-00004 2955:10.1111/j.1464-410X.2006.06213.x 2827:10.1111/j.1468-3083.2010.03969.x 2792:10.1016/j.critrevonc.2008.02.012 2528:10.1111/j.1525-1470.2009.01022.x 2374:10.1046/j.1365-2133.2001.04287.x 2273:10.2165/00128071-200405020-00005 1993:10.1111/j.1479-828X.2010.01142.x 1891:10.1046/j.1365-2133.2002.05012.x 1839:10.1111/j.1365-2133.2010.09997.x 1598:10.1046/j.1525-1438.1999.99016.x 1468:10.1046/j.1464-410X.2000.00772.x 1425:10.1111/j.1365-4632.2006.02978.x 1198:10.1111/j.1365-2133.2004.05707.x 1012:10.1111/j.1468-3083.2010.03572.x 852:European Journal of Cell Biology 509:linked with Borrelia infection. 3945:Acquired perforating dermatosis 3935:Elastosis perforans serpiginosa 3875:Jadassohn–Pellizzari anetoderma 2977: 2898:International Journal of Cancer 2806: 2663: 2507: 2059: 2023: 1534: 1344: 1077: 991: 948: 905: 735:European Journal of Dermatology 486: 398:can have a similar appearance. 228: 3369:Irritated seborrheic keratosis 2871:10.1001/jamadermatol.2016.1336 2747:10.1001/jamadermatol.2018.1373 2362:British Journal of Dermatology 2317:British Journal of Dermatology 2172:10.1001/jamadermatol.2015.0643 2114:10.1002/14651858.CD008240.pub2 1879:British Journal of Dermatology 1826:British Journal of Dermatology 1678:British Journal of Dermatology 1395:Lichen Sclerosus et Atrophicus 1186:British Journal of Dermatology 1043:British Journal of Dermatology 776:National Institute of Health. 769: 699: 655: 1: 3902:Linear atrophoderma of Moulin 3574:Patch-type granuloma annulare 3450:Inverted follicular keratosis 2984:Fistarol, Susanna K. (2013). 2649:10.1016/S0022-5347(05)00735-4 2571:10.1016/S0190-9622(99)70245-8 1788:10.1016/S0190-9622(99)70496-2 558: 102:balanitis xerotica obliterans 3870:Schweninger–Buzzi anetoderma 3569:Localized granuloma annulare 1559:10.1097/AOG.0b013e31817578ba 641:10.1016/0190-9622(95)90060-8 543:List of cutaneous conditions 471: 421:Methylprednisolone aceponate 401: 394:, and the cutaneous rash of 327: 300:is shown by the presence of 259: 7: 3596:Necrobiotic xanthogranuloma 3495:Waxy keratosis of childhood 3364:Common seborrheic keratosis 3359:Clonal seborrheic keratosis 3341:Keratoderma blennorrhagicum 1546:Obstetrics & Gynecology 1330:10.1001/archderm.121.8.1044 531: 520:was dropped in 1976 by the 307: 10: 4044: 3312:Paraneoplastic keratoderma 2689:10.1186/s40001-023-01335-9 2311:Salad, A.A. (April 2018). 2045:10.1016/j.jpag.2012.11.010 1945:10.1001/archderm.140.6.709 1744:10.1001/archderm.135.5.525 1520:10.1016/j.jaad.2012.02.044 1241:10.1001/archderm.144.5.591 1102:10.1016/j.ijwd.2017.02.017 864:10.1016/j.ejcb.2004.12.003 498: 435:, mometasone furoate, and 344:of collagen in the dermis. 220: 18: 4023:Ailments of unknown cause 3971: 3953: 3915: 3845: 3785: 3720: 3705: 3676: 3623: 3534: 3521: 3384:Dermatosis papulosa nigra 3307:Keratoderma climactericum 3293: 3231: 3172: 3002:10.1007/s40257-012-0006-4 2477:10.1007/s11255-017-1523-0 2425:10.1080/00365590600589666 2220:10.1007/s40257-012-0006-4 79: 71:(right/bottom of image). 63: 54: 45: 36: 31: 3940:Perforating folliculitis 3892:Semicircular lipoatrophy 3329:Drug-induced keratoderma 3035:Southern Medical Journal 1552:(5): 1243–53. May 2008. 821:10.1258/0956462054308440 514:François Henri Hallopeau 246:diabetes mellitus type 1 3897:Follicular atrophoderma 3685:eosinophilic dermatosis 1933:Archives of Dermatology 1732:Archives of Dermatology 1318:Archives of Dermatology 1229:Archives of Dermatology 712:Vulvodynia Media Corner 708:"Vulvodynia Fact Sheet" 602:Autoimmune Registry Inc 285:. Viral involvement of 256:, and thyroid disease. 3625:Foreign body granuloma 3536:Necrobiotic/palisading 3430:Chronic scar keratosis 1357:Our Dermatology Online 429:calcineurin inhibitors 359:, atrophic epidermis, 345: 304:in LSA biopsy tissue. 211:genetic predisposition 141: 133: 3800:Localized scleroderma 3581:Necrobiosis lipoidica 3513:Cutis verticis gyrata 3440:Hydrocarbon keratosis 3324:Aquagenic keratoderma 2516:Pediatric Dermatology 1370:10.7241/ourd.20182.24 1143:Pediatric Dermatology 747:10.1684/ejd.2019.3580 433:clobetasol propionate 335: 139: 127: 3963:Pyoderma gangrenosum 3825:Pansclerotic morphea 3606:Rheumatoid nodulosis 3591:Granuloma multiforme 3470:Reactional keratosis 3420:Ichthyosis acquisita 3403:Acanthosis nigricans 3354:Seborrheic keratosis 3295:Epidermal thickening 466:Platelet-rich plasma 460:Carbon dioxide laser 302:Borrelia burgdorferi 293:are also suspected. 282:Borrelia burgdorferi 182:Psychological effect 21:BXO (disambiguation) 4028:Lichenoid eruptions 3815:Generalized morphea 3653:Zirconium granuloma 3633:Beryllium granuloma 3501:other hypertrophy: 3455:Lichenoid keratosis 3425:Arsenical keratosis 203:autoimmune diseases 3835:Linear scleroderma 3648:Silicone granuloma 3544:Granuloma annulare 3232:External resources 2637:Journal of Urology 598:"Lichen sclerosus" 425:mometasone furoate 346: 320:Local skin changes 142: 134: 120:Signs and symptoms 4010: 4009: 4006: 4005: 3805:Localized morphea 3777:Rowell's syndrome 3701: 3700: 3691:Granuloma faciale 3638:Mercury granuloma 3508:Hypertrophic scar 3490:Warty dyskeratoma 3480:Thermal keratosis 3255: 3254: 2943:BJU International 2911:10.1002/ijc.30621 2330:10.1111/bjd.16241 1456:BJU International 276:is caused by the 91: 90: 26:Medical condition 4035: 3979:Calcinosis cutis 3860:Lichen sclerosus 3830:Morphea profunda 3718: 3717: 3643:Silica granuloma 3532: 3531: 3475:Stucco keratosis 3282: 3275: 3268: 3259: 3258: 3170: 3169: 3148:Medical pictures 3109: 3108: 3088: 3082: 3081: 3073: 3067: 3066: 3030: 3024: 3023: 3013: 2981: 2975: 2974: 2938: 2932: 2931: 2913: 2904:(9): 1998–2002. 2889: 2883: 2882: 2859:JAMA Dermatology 2853: 2847: 2846: 2810: 2804: 2803: 2775: 2769: 2768: 2758: 2735:JAMA Dermatology 2726: 2720: 2719: 2709: 2691: 2667: 2661: 2660: 2643:(4): 1359–1363. 2632: 2626: 2625: 2589: 2583: 2582: 2554: 2548: 2547: 2511: 2505: 2504: 2459: 2453: 2452: 2408: 2402: 2401: 2357: 2351: 2350: 2332: 2307: 2301: 2300: 2256: 2250: 2249: 2239: 2199: 2193: 2192: 2174: 2159:JAMA Dermatology 2150: 2144: 2143: 2133: 2108:(12): CD008240. 2093: 2084: 2083: 2063: 2057: 2056: 2027: 2021: 2020: 1976: 1965: 1964: 1928: 1919: 1918: 1874: 1868: 1867: 1841: 1817: 1808: 1807: 1770: 1764: 1763: 1727: 1718: 1717: 1673: 1667: 1666: 1640: 1616: 1610: 1609: 1581: 1572: 1571: 1561: 1538: 1532: 1531: 1502: 1496: 1495: 1451: 1445: 1444: 1419:(9): 1104–1106. 1408: 1402: 1391: 1385: 1382: 1372: 1348: 1342: 1341: 1324:(8): 1044–1047. 1313: 1307: 1306: 1286: 1280: 1279: 1259: 1253: 1252: 1224: 1218: 1217: 1181: 1175: 1174: 1138: 1132: 1131: 1121: 1081: 1075: 1074: 1038: 1032: 1031: 1006:(9): 1031–1034. 995: 989: 988: 952: 946: 945: 909: 903: 902: 882: 876: 875: 858:(2–3): 273–277. 847: 841: 840: 804: 798: 797: 795: 793: 782:Lichen Sclerosus 773: 767: 766: 730: 724: 723: 721: 719: 703: 697: 696: 668: 662: 659: 653: 652: 624: 613: 612: 610: 608: 594: 588: 587: 569: 526:lichen sclerosus 481:vulvar carcinoma 455:Other treatments 94:Lichen sclerosus 59: 50: 41:kraurosis vulvae 32:Lichen sclerosus 29: 28: 4043: 4042: 4038: 4037: 4036: 4034: 4033: 4032: 4013: 4012: 4011: 4002: 3967: 3949: 3911: 3850: 3841: 3790: 3781: 3723: 3722:Cutaneous lupus 3710: 3697: 3677:Other/ungrouped 3672: 3619: 3517: 3485:Viral keratosis 3289: 3286: 3256: 3251: 3250: 3227: 3226: 3181: 3137:better medicine 3118: 3113: 3112: 3089: 3085: 3074: 3070: 3031: 3027: 2982: 2978: 2939: 2935: 2890: 2886: 2854: 2850: 2811: 2807: 2776: 2772: 2727: 2723: 2668: 2664: 2633: 2629: 2590: 2586: 2555: 2551: 2512: 2508: 2460: 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