Lichen sclerosus

Lichen sclerosus (LSc) is a chronic, inflammatory skin disease, of disputed cause, which can affect any body part of any person, but has a strong predilection for the genitals (penis, vulva); it has historically been called balanitis xerotica obliterans when it affects the penis. LSc is not contagious. There is a well-documented increase of genital cancer risk in LSc, potentially much reduced with early diagnosis and effective, definitive treatment, especially in men. LSc in adult age women is held to be 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 the foreskin or the glans penis can be cured by either medical or surgical treatment.

Signs and symptoms

LSc can occur without symptoms. White patches on the affected area, itching, pain, dyspareunia (in genital LSc), 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 vulva and around the anus with ivory-white elevations that may be flat and glistening. In men, difficulty retracting the foreskin, tightening of the foreskin and episodes of 'thrush' or cystitis, prostatitis and urethritis may be accompanying features of the history. An acute presentation is paraphimosis, where the foreskin has become fixed in the retracted state and cannot be replaced.