Lichen sclerosus - Knowledge (XXG)

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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.

59: 344: 148: 68: 136: 119:) 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 450:(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. 422:

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

494:. 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%". 200:

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".

3276: 111:) 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 159:(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 1152:

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.

174:). In addition there can be lesions, white patches or reddening on the glans. In contrast to women, anal involvement is less frequent. 4033: 3999: 3892: 3830: 389:

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".

795:. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Archived from 426: 367: 283:

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".

2708: 2683:"Comorbidity in patients with Lichen sclerosus: a retrospective cohort study" 2495: 2443: 2392: 2291: 2238: 2191: 2132: 2011: 1963: 1909: 1858: 1806: 1762: 1708: 1657: 1486: 1389: 1120: 831: 3546: 3537: 3360: 3345: 3251: 1410: 564:

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

2997:"Diagnosis and treatment of lichen sclerosus: an update" 2164:

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

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

127:, can be cured by either medical or surgical treatment. 2166:"Long-term Management of Adult Vulvar Lichen Sclerosus" 1630:

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

1364:"Dermoscopic findings in extragenital lichen sclerosus" 1985: 1983: 1981: 506:

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

2109:"Topical interventions for genital lichen sclerosus" 3982: 3964: 3926: 3856: 3796: 3731: 3716: 3687: 3634: 3612:

Palisaded neutrophilic and granulomatous dermatitis

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Andrews' Diseases of the Skin: clinical Dermatology

224:. There is evidence that LS can be associated with 212:Several risk factors have been proposed, including 90: 47: 42: 3773:Lupus erythematosus–lichen planus overlap syndrome 1826: 1824: 517:International Society for Study of Vulvar Disease 151:Balanitis xerotica obliterans. 70 year old man. 3821:Morphea–lichen sclerosus et atrophicus overlap 3102:Friedrich Jr., EG (1976). "Lichen sclerosus". 3001:Journal of the American Academy of Dermatology 2570:Journal of the American Academy of Dermatology 2424:Scandinavian Journal of Urology and Nephrology 2044:Journal of Pediatric and Adolescent Gynecology 1787:Journal of the American Academy of Dermatology 1590: 1588: 1519:Journal of the American Academy of Dermatology 1395:- "Figures - available via license: CC BY 4.0" 640:Journal of the American Academy of Dermatology 583:James, William D.; Berger, Timothy G. (2006). 27:Itchy skin rash usually affecting the genitals 3284: 2215:"Diagnosis and Treatment of Lichen Sclerosus" 2213:Fistarol, Susanna K.; Itin, Peter H. (2012). 1597:International Journal of Gynecological Cancer 8: 3089:Annales de Dermatologie et de Syphiligraphie 1632:"Lichen sclerosus and the Kobner phenomenon" 1101:International Journal of Women's Dermatology 2113:The Cochrane Database of Systematic Reviews 2077:Maassen, M.S.; van Doorn, H.C. (2012). "". 684:AMA Archives of Dermatology and Syphilology 3728: 3542: 3291: 3277: 3269: 3180: 633: 631: 629: 66: 57: 39: 30:"BXO" redirects here. For other uses, see 3385:Seborrheic keratosis with squamous atypia 3138:NIAMS – Fast Facts About Lichen Sclerosus 3020: 2920: 2765: 2716: 2698: 2339: 2246: 2181: 2140: 1848: 1647: 1568: 1379: 1128: 535:(ISSVD), officially proclaiming the name 3626:Interstitial granulomatous drug reaction 3597:Annular elastolytic giant-cell granuloma 3419:Confluent and reticulated papillomatosis 3402:Keratosis punctata of the palmar creases 2272:American Journal of Clinical Dermatology 2219:American Journal of Clinical Dermatology 134: 3471:Multiple minute digitate hyperkeratosis 3456:Hyperkeratosis of the nipple and areola 2791:Critical Reviews in Oncology/Hematology 2079:Nederlands Tijdschrift voor Geneeskunde 820:International Journal of STD & AIDS 575: 3328:Acrokeratosis paraneoplastica of Bazex 3918:Atrophia maculosa varioliformis cutis 3622:Interstitial granulomatous dermatitis 2905:"Lichen sclerosus and risk of cancer" 2102: 2100: 1636:Clinical and Experimental Dermatology 1302:Clinical and Experimental Dermatology 1166:10.1046/j.1525-1470.1998.1998015085.x 255:of other autoimmune diseases such as 7: 3446:Hyperkeratosis lenticularis perstans 3104:The Journal of Reproductive Medicine 2687:European Journal of Medical Research 2476:International Urology and Nephrology 1424:International Journal of Dermatology 1097:"Lichenoid vulvar disease: A review" 898:The Journal of Reproductive Medicine 696:10.1001/archderm.1951.01570110090013 3898:Acrodermatitis chronica atrophicans 789:"Fast Facts About Lichen Sclerosus" 285:acrodermatitis chronica atrophicans 4000:Poikiloderma vasculare atrophicans 3893:Atrophoderma of Pasini and Pierini 3831:Atrophoderma of Pasini and Pierini 2617:10.1034/j.1600-0463.2003.1110901.x 1701:10.1111/j.1365-2133.1991.tb00626.x 1649:10.1111/j.1365-2230.1994.tb01183.x 1066:10.1111/j.1365-2133.1988.tb01748.x 980:10.1111/j.1365-2133.1986.tb06659.x 968:The British Journal of Dermatology 937:10.1111/j.1365-2133.1986.tb02831.x 925:The British Journal of Dermatology 587:. Saunders Elsevier. p. 227. 25: 3941:Reactive perforating collagenosis 3575:Granuloma annulare in HIV disease 725:. National Vulvodynia Association 717:National Vulvodynia Association. 3390:Reticulated seborrheic keratosis 3058:10.1097/00007611-200301000-00004 2966:10.1111/j.1464-410X.2006.06213.x 2838:10.1111/j.1468-3083.2010.03969.x 2803:10.1016/j.critrevonc.2008.02.012 2539:10.1111/j.1525-1470.2009.01022.x 2385:10.1046/j.1365-2133.2001.04287.x 2284:10.2165/00128071-200405020-00005 2004:10.1111/j.1479-828X.2010.01142.x 1902:10.1046/j.1365-2133.2002.05012.x 1850:10.1111/j.1365-2133.2010.09997.x 1609:10.1046/j.1525-1438.1999.99016.x 1479:10.1046/j.1464-410X.2000.00772.x 1436:10.1111/j.1365-4632.2006.02978.x 1209:10.1111/j.1365-2133.2004.05707.x 1023:10.1111/j.1468-3083.2010.03572.x 863:European Journal of Cell Biology 520:linked with Borrelia infection. 3956:Acquired perforating dermatosis 3946:Elastosis perforans serpiginosa 3886:Jadassohn–Pellizzari anetoderma 2909:International Journal of Cancer 746:European Journal of Dermatology 409:can have a similar appearance. 3380:Irritated seborrheic keratosis 2882:10.1001/jamadermatol.2016.1336 2758:10.1001/jamadermatol.2018.1373 2373:British Journal of Dermatology 2328:British Journal of Dermatology 2183:10.1001/jamadermatol.2015.0643 2125:10.1002/14651858.CD008240.pub2 1890:British Journal of Dermatology 1837:British Journal of Dermatology 1689:British Journal of Dermatology 1406:Lichen Sclerosus et Atrophicus 1197:British Journal of Dermatology 1054:British Journal of Dermatology 787:National Institute of Health. 1: 3913:Linear atrophoderma of Moulin 3585:Patch-type granuloma annulare 3461:Inverted follicular keratosis 2995:Fistarol, Susanna K. (2013). 2660:10.1016/S0022-5347(05)00735-4 2582:10.1016/S0190-9622(99)70245-8 1799:10.1016/S0190-9622(99)70496-2 113:balanitis xerotica obliterans 18:Balanitis xerotica obliterans 3881:Schweninger–Buzzi anetoderma 3580:Localized granuloma annulare 1570:10.1097/AOG.0b013e31817578ba 652:10.1016/0190-9622(95)90060-8 554:List of cutaneous conditions 432:Methylprednisolone aceponate 405:, and the cutaneous rash of 311:is shown by the presence of 3607:Necrobiotic xanthogranuloma 3506:Waxy keratosis of childhood 3375:Common seborrheic keratosis 3370:Clonal seborrheic keratosis 3352:Keratoderma blennorrhagicum 1557:Obstetrics & Gynecology 1341:10.1001/archderm.121.8.1044 531:was dropped in 1976 by the 4055: 3323:Paraneoplastic keratoderma 2700:10.1186/s40001-023-01335-9 2322:Salad, A.A. (April 2018). 2056:10.1016/j.jpag.2012.11.010 1956:10.1001/archderm.140.6.709 1755:10.1001/archderm.135.5.525 1531:10.1016/j.jaad.2012.02.044 1252:10.1001/archderm.144.5.591 1113:10.1016/j.ijwd.2017.02.017 875:10.1016/j.ejcb.2004.12.003 446:, mometasone furoate, and 355:of collagen in the dermis. 29: 4034:Ailments of unknown cause 3395:Dermatosis papulosa nigra 3318:Keratoderma climactericum 3013:10.1007/s40257-012-0006-4 2488:10.1007/s11255-017-1523-0 2436:10.1080/00365590600589666 2231:10.1007/s40257-012-0006-4 82:(right/bottom of image). 74: 65: 56: 3951:Perforating folliculitis 3903:Semicircular lipoatrophy 3340:Drug-induced keratoderma 3046:Southern Medical Journal 1563:(5): 1243–53. May 2008. 832:10.1258/0956462054308440 525:François Henri Hallopeau 257:diabetes mellitus type 1 3908:Follicular atrophoderma 3696:eosinophilic dermatosis 1944:Archives of Dermatology 1743:Archives of Dermatology 1329:Archives of Dermatology 1240:Archives of Dermatology 723:Vulvodynia Media Corner 719:"Vulvodynia Fact Sheet" 613:Autoimmune Registry Inc 296:. Viral involvement of 267:, and thyroid disease. 3636:Foreign body granuloma 3547:Necrobiotic/palisading 3441:Chronic scar keratosis 1368:Our Dermatology Online 440:calcineurin inhibitors 370:, atrophic epidermis, 356: 315:in LSA biopsy tissue. 222:genetic predisposition 152: 144: 3811:Localized scleroderma 3592:Necrobiosis lipoidica 3524:Cutis verticis gyrata 3451:Hydrocarbon keratosis 3335:Aquagenic keratoderma 2527:Pediatric Dermatology 1381:10.7241/ourd.20182.24 1154:Pediatric Dermatology 758:10.1684/ejd.2019.3580 444:clobetasol propionate 346: 150: 138: 3974:Pyoderma gangrenosum 3836:Pansclerotic morphea 3617:Rheumatoid nodulosis 3602:Granuloma multiforme 3481:Reactional keratosis 3431:Ichthyosis acquisita 3414:Acanthosis nigricans 3365:Seborrheic keratosis 3306:Epidermal thickening 477:Platelet-rich plasma 471:Carbon dioxide laser 313:Borrelia burgdorferi 304:are also suspected. 293:Borrelia burgdorferi 193:Psychological effect 32:BXO (disambiguation) 4039:Lichenoid eruptions 3826:Generalized morphea 3664:Zirconium granuloma 3644:Beryllium granuloma 3512:other hypertrophy: 3466:Lichenoid keratosis 3436:Arsenical keratosis 214:autoimmune diseases 3846:Linear scleroderma 3659:Silicone granuloma 3555:Granuloma annulare 3243:External resources 2648:Journal of Urology 609:"Lichen sclerosus" 436:mometasone furoate 357: 331:Local skin changes 153: 145: 131:Signs and symptoms 4021: 4020: 4017: 4016: 3816:Localized morphea 3788:Rowell's syndrome 3712: 3711: 3702:Granuloma faciale 3649:Mercury granuloma 3519:Hypertrophic scar 3501:Warty dyskeratoma 3491:Thermal keratosis 3266: 3265: 2954:BJU International 2922:10.1002/ijc.30621 2341:10.1111/bjd.16241 1467:BJU International 287:is caused by the 102: 101: 37:Medical condition 16:(Redirected from 4046: 3990:Calcinosis cutis 3871:Lichen sclerosus 3841:Morphea profunda 3729: 3654:Silica granuloma 3543: 3486:Stucco keratosis 3293: 3286: 3279: 3270: 3181: 3159:Medical pictures 3120: 3119: 3099: 3093: 3092: 3084: 3078: 3077: 3041: 3035: 3034: 3024: 2992: 2986: 2985: 2949: 2943: 2942: 2924: 2915:(9): 1998–2002. 2900: 2894: 2893: 2870:JAMA Dermatology 2864: 2858: 2857: 2821: 2815: 2814: 2786: 2780: 2779: 2769: 2746:JAMA Dermatology 2737: 2731: 2730: 2720: 2702: 2678: 2672: 2671: 2654:(4): 1359–1363. 2643: 2637: 2636: 2600: 2594: 2593: 2565: 2559: 2558: 2522: 2516: 2515: 2470: 2464: 2463: 2419: 2413: 2412: 2368: 2362: 2361: 2343: 2318: 2312: 2311: 2267: 2261: 2260: 2250: 2210: 2204: 2203: 2185: 2170:JAMA Dermatology 2161: 2155: 2154: 2144: 2119:(12): CD008240. 2104: 2095: 2094: 2074: 2068: 2067: 2038: 2032: 2031: 1987: 1976: 1975: 1939: 1930: 1929: 1885: 1879: 1878: 1852: 1828: 1819: 1818: 1781: 1775: 1774: 1738: 1729: 1728: 1684: 1678: 1677: 1651: 1627: 1621: 1620: 1592: 1583: 1582: 1572: 1549: 1543: 1542: 1513: 1507: 1506: 1462: 1456: 1455: 1430:(9): 1104–1106. 1419: 1413: 1402: 1396: 1393: 1383: 1359: 1353: 1352: 1335:(8): 1044–1047. 1324: 1318: 1317: 1297: 1291: 1290: 1270: 1264: 1263: 1235: 1229: 1228: 1192: 1186: 1185: 1149: 1143: 1142: 1132: 1092: 1086: 1085: 1049: 1043: 1042: 1017:(9): 1031–1034. 1006: 1000: 999: 963: 957: 956: 920: 914: 913: 893: 887: 886: 869:(2–3): 273–277. 858: 852: 851: 815: 809: 808: 806: 804: 793:Lichen Sclerosus 784: 778: 777: 741: 735: 734: 732: 730: 714: 708: 707: 679: 673: 670: 664: 663: 635: 624: 623: 621: 619: 605: 599: 598: 580: 537:lichen sclerosus 492:vulvar carcinoma 466:Other treatments 105:Lichen sclerosus 70: 61: 52:kraurosis vulvae 43:Lichen sclerosus 40: 21: 4054: 4053: 4049: 4048: 4047: 4045: 4044: 4043: 4024: 4023: 4022: 4013: 3978: 3960: 3922: 3861: 3852: 3801: 3792: 3734: 3733:Cutaneous lupus 3721: 3708: 3688:Other/ungrouped 3683: 3630: 3528: 3496:Viral keratosis 3300: 3297: 3267: 3262: 3261: 3238: 3237: 3192: 3148:better medicine 3129: 3124: 3123: 3101: 3100: 3096: 3086: 3085: 3081: 3043: 3042: 3038: 2994: 2993: 2989: 2951: 2950: 2946: 2902: 2901: 2897: 2866: 2865: 2861: 2823: 2822: 2818: 2788: 2787: 2783: 2739: 2738: 2734: 2680: 2679: 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333: 321: 273: 265:alopecia areata 242: 234: 226:thyroid disease 207: 205:Pathophysiology 195: 176:Meatal stenosis 163:and around the 133: 38: 35: 28: 23: 22: 15: 12: 11: 5: 4052: 4050: 4042: 4041: 4036: 4026: 4025: 4019: 4018: 4015: 4014: 4012: 4011: 4002: 3997: 3992: 3986: 3984: 3980: 3979: 3977: 3976: 3970: 3968: 3962: 3961: 3959: 3958: 3953: 3948: 3943: 3938: 3932: 3930: 3924: 3923: 3921: 3920: 3915: 3910: 3905: 3900: 3895: 3890: 3889: 3888: 3883: 3873: 3867: 3865: 3854: 3853: 3851: 3850: 3849: 3848: 3843: 3838: 3833: 3828: 3823: 3818: 3807: 3805: 3794: 3793: 3791: 3790: 3785: 3780: 3775: 3770: 3763: 3762: 3752: 3751: 3746: 3739: 3737: 3726: 3714: 3713: 3710: 3709: 3707: 3706: 3705: 3704: 3691: 3689: 3685: 3684: 3682: 3681: 3676: 3671: 3666: 3661: 3656: 3651: 3646: 3640: 3638: 3632: 3631: 3629: 3628: 3619: 3614: 3609: 3604: 3599: 3594: 3589: 3588: 3587: 3582: 3577: 3572: 3567: 3562: 3551: 3549: 3540: 3530: 3529: 3527: 3526: 3521: 3516: 3509: 3508: 3503: 3498: 3493: 3488: 3483: 3478: 3476:PUVA keratosis 3473: 3468: 3463: 3458: 3453: 3448: 3443: 3438: 3433: 3428: 3423: 3422: 3421: 3410:hyperkeratosis 3405: 3404: 3399: 3398: 3397: 3392: 3387: 3382: 3377: 3372: 3357: 3356: 3355: 3354: 3342: 3337: 3332: 3331: 3330: 3320: 3310: 3308: 3302: 3301: 3298: 3296: 3295: 3288: 3281: 3273: 3264: 3263: 3260: 3259: 3247: 3246: 3244: 3240: 3239: 3236: 3235: 3224: 3209: 3193: 3188: 3187: 3185: 3184:Classification 3178: 3177: 3172: 3167: 3156: 3155: 3150: 3145: 3140: 3135: 3128: 3127:External links 3125: 3122: 3121: 3110:(3): 147–154. 3094: 3079: 3036: 2987: 2944: 2895: 2859: 2816: 2797:(2): 131–156. 2781: 2752:(7): 819–823. 2732: 2673: 2638: 2611:(9): 835–842. 2595: 2576:(6): 911–914. 2560: 2517: 2482:(4): 573–580. 2465: 2430:(3): 208–211. 2414: 2363: 2334:(4): 839–853. 2313: 2278:(2): 105–125. 2262: 2205: 2176:(10): 1061–7. 2156: 2096: 2069: 2033: 1998:(2): 148–152. 1977: 1950:(6): 709–712. 1931: 1896:(4): 640–649. 1880: 1843:(4): 672–682. 1820: 1793:(3): 451–457. 1776: 1730: 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3942: 3939: 3937: 3936:Kyrle disease 3934: 3933: 3931: 3929: 3925: 3919: 3916: 3914: 3911: 3909: 3906: 3904: 3901: 3899: 3896: 3894: 3891: 3887: 3884: 3882: 3879: 3878: 3877: 3874: 3872: 3869: 3868: 3866: 3864: 3859: 3855: 3847: 3844: 3842: 3839: 3837: 3834: 3832: 3829: 3827: 3824: 3822: 3819: 3817: 3814: 3813: 3812: 3809: 3808: 3806: 3804: 3799: 3795: 3789: 3786: 3784: 3781: 3779: 3776: 3774: 3771: 3769: 3765: 3764: 3761: 3757: 3754: 3753: 3750: 3747: 3745: 3741: 3740: 3738: 3736: 3735:erythematosus 3730: 3727: 3725: 3719: 3715: 3703: 3700: 3699: 3698: 3697: 3693: 3692: 3690: 3686: 3680: 3677: 3675: 3672: 3670: 3667: 3665: 3662: 3660: 3657: 3655: 3652: 3650: 3647: 3645: 3642: 3641: 3639: 3637: 3633: 3627: 3623: 3620: 3618: 3615: 3613: 3610: 3608: 3605: 3603: 3600: 3598: 3595: 3593: 3590: 3586: 3583: 3581: 3578: 3576: 3573: 3571: 3568: 3566: 3563: 3561: 3558: 3557: 3556: 3553: 3552: 3550: 3548: 3544: 3541: 3539: 3535: 3531: 3525: 3522: 3520: 3517: 3515: 3511: 3510: 3507: 3504: 3502: 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