User:Mr. Ibrahem/Lichen sclerosus

Lichen sclerosus (LS) is a long-term, inflammatory skin disease that affects mainly the genital area. It tends to begin as irregular flat-topped small bumps which become shiny, slightly wrinkled, pale-white patches surrounded by a purplish area. It is extremely itchy and scratching may cause thinning of the skin with small cuts and scarring. Tiny blood vessels may be seen on the vulva or penis. Loss of pigmentation is common on the penis. It rarely occurs elsewhere, though may involve the upper back or breast. Sometimes there are no symptoms. It can lead to pain with urination, vaginal discharge, reluctance to pass stool, problems with sex, and is associated with an increased risk of skin cancer.

The cause is unknown. It is possibly triggered by infection, trauma, and the genital area's tendency to being moist. Bone marrow transplantation may also be a trigger. In transgender people it can occur at surgical sites.

Diagnosis is generally by examination. It can be confirmed by skin biopsy, which shows thick dermal collagen and thin epidermis. LS may appear similar to guttate morphea, lichen planus, and lichen simplex chronicus. Treatment involves strong topical steroids. Sometimes, particularly in children, it gets better without further treatment.

Lichen sclerosus affects around 1.7% of adult females. It typically occurs before puberty and after menopause. In males, it can occur at any age. African Americans are less frequently affected. Up to one third of females have another autoimmune disease. Up to 17% have psoriasis. Lichen sclerosus et atrophicus was first described in 1887 by Dr. Hallopeau.