Lichen sclerosus et atroficus is often abbreviated to lichen sclerosus. It is a skin disease with the main symptom being pearly spots that later turn into a white rash. There is itching and pain. Often also a burning sensation. Applying all kinds of ointments does not help or does not help much and the complaints keep coming back. In most cases, the disease occurs in women. Both adults and children can get it. It is probably an autoimmune disease. Treatment is necessary because skin cancer can develop in a small number of cases.
What is lichen sclerosus et atroficus?
The name lichen sclerosus et atroficus is also written as lichen sclerosus (et atropicus). The last words et atrophicus/atroficus have often been omitted lately. It is a skin disease in which pearly plaques develop on the skin, but also on the mucous membranes.
The mouth and genitals
This skin disease mainly occurs in the mouth and on the genitals/genitals. In 20 percent of cases it (also) occurs in other places on the skin. We mainly see it around the navel, on the elbows, in the back of the knees and in the neck. The disease mainly occurs after puberty and mainly in older women. The disease can also occur in children, especially in the age group of 4 to 7 years. It occurs in 0.25% of the population. In the Netherlands, an average of 42,000 people suffer from this disease. Lichen sclerosus was first described in 1887. Various names were given to the skin disease, but in 1989 it was decided that the disease was given the name lichen sclerosus.
Cause
Lichen sclerosus is thought to be an autoimmune disease. The immune system reacts incorrectly to the body’s own substances. It starts to see the body’s own substances as foreign and attacks them. Antibodies are produced. Antibodies are proteins that are produced in response to the presence of antigens. These proteins attack the foreign substance. In the case of an autoimmune disease, the body’s own tissue is attacked. Lichen sclerosus is not associated with infection from others or with heredity.
Symptoms
In lichen sclerosus, pearly spots develop on the mucous membranes and/or the skin. Later this turns into a whitish rash. Symptoms such as itching, burning sensation and pain occur. At a later stage, deformities, scarring and shriveling of the skin occur. The elasticity of the skin is clearly reduced in the affected area. Sometimes bumps and bleeding occur.
Many women in particular suffer from vague complaints for years without knowing that they have the disease. Sometimes the doctor has no idea or suspicion. The white rash is often mistaken for an excessive white discharge (white discharge). There are complaints such as severe itching and pain. Despite various ointments they try, the complaints do not disappear. Taking a smear is often painful, but usually shows no abnormalities. An abnormal smear is not related to lichen sclerosus.
Squamous cell carcinoma
In a small number of cases, squamous cell carcinoma develops due to long-term lichen sclerosus. Squamous cell carcinoma is a malignant tumor, a skin tumor. We also call this skin cancer. Most skin tumors consist of a basal cell carcinoma that does not spread. Squamous cell carcinoma easily spreads to other organs. Squamous cell carcinoma almost always arises in the top layer of the skin, also called the epidermis. The chance of squamous cell carcinoma is 3 to 5 percent.
Therapy
The treatment consists of combating the itching and preventing the disease. A corticosteroid cream will often be used for this. We also call this a hormone ointment. This is based on the adrenal cortex hormone. The ointment should be used with great care. Applying the ointment too heavily causes the skin to become permanently thin and has side effects. The doctor determines how often and how much can be applied. There are many different types of hormone ointments, each with a different name. In between, a greasy ointment is often applied to keep the skin supple.
Good hygiene is important, especially when the disease is in the genitals. Sometimes treatment is based on testosterone (men) or estrogen (women). A CO2 laser treatment is also sometimes applied. In case of deformity, surgery is sometimes necessary.
In the case of squamous cell carcinoma, it is important to treat it as quickly as possible. This can be done through surgery. Sometimes chemotherapy or radiotherapy is also necessary. There are also other treatments available for cancer. The doctor always discusses in advance what these are and what the expected results are.
