Lichen Sclerosus et Atrophicus

Lichen Sclerosus et Atrophicus is an acquired, chronic, inflammatory, and fibrous disease, that causes scarring.

LSA affects both females and males

  • It appears to be caused by an interaction of external and idiosyncratic factors, such as chronic irritation from small amounts of urine, anatomic blocking, sensitivity of the epithelium, and how the latter reacts to an injury.
  • We should always consider the possibility of SCC, and perform biopsy where it is clinically necessary.
  • The treatment option is to apply topical steroids, combined with a regenerative-blocking cream, cleanser without soaps & changes in the patient’s hygiene.
  • LSA can cause major morbidity, with urination dysfunction, and very often dyspareunia.

In males, it is extremely rare, when circumcision was performed at birth, which implies that the foreskin plays a role in the pathogenesis of LSA.

  • A common finding is a ring-shaped fibrous bundle that sometimes causes phimosis or just difficulty or pain when pulling back the foreskin.
  • Another common finding are Zoon’s balanitis type lesions, and erythema.
  • Circumcision is a very effective solution, and fortunately, it is only needed by a small number of males.

In females, the disease shows two age distribution peaks – a preadolescent and a postmenopause.

Itching is pronounced, especially in the anogenital area, while the development of stretch marks and corrosion is possible. This fact can cause dysuria, dyspareunia, and a burning sense. In many cases, the natural anatomic structures atrophy, and the labia are not visible, as a result.

Perianal infection can result in severe symptomatology in both genders.

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