Lichen sclerosus - Anogenital in
The main symptom is pruritus, and at times, this can be incapacitating, interfering with daily activity and sleep. Dyspareunia and urinary retention may occur. It can also be asymptomatic, just with scarring and hypopigmentation.
Squamous cell carcinoma (SCC) can occur within LS genital lesions. There is a higher risk of SCC in untreated cases.
L90.0 – Lichen sclerosus et atrophicus
895454001 – Lichen sclerosus
- Bowen disease – Four percent of patients can have an associated squamous cell carcinoma.
- Chronic radiation dermatitis – Previously radiated in that area.
- Mucous membrane pemphigoid – Look for blisters and erosions, scarring, and stricture formation in later stages.
- Extramammary Paget disease – Look for lichenified or verrucous, dry to macerated plaques.
- Infiltrating basal cell carcinoma – Look for pearly areas and prominent telangiectasias.
- Lichen planus – Look for white streaks (Wickham striae).
- Lichen simplex chronicus – Look for lichenification with exaggerated skin markings on glabrous areas of vulva only, often with excoriations.
- Postmenopausal atrophy – Postmenopausal patient with vaginal dryness and atrophy.
- Psoriasis – Look for psoriasis on other body sites.
- Scar – History of trauma.
- Vitiligo – Bright white fluorescence on Wood's lamp.
- Bullous pemphigoid
- Recessive dystrophic epidermolysis bullosa (vulvar lesions)
- Junctional epidermolysis bullosa (vulvar lesions)