Laboratory parameters of 1st order – obligatory laboratory tests. Skin biopsies (sampling)/punch biopsies 3-6 mm in diameter under local anesthesia/local anesthesia) – to confirm the diagnosis (all suspected cases should be clarified histologically (fine tissue)!)Indication for a punch biopsy: Unclear diagnosis Appearance of new lesions such as ulcers (boils) or nodules High potency corticosteroid ointment … Lichen Sclerosus: Test and Diagnosis
Therapeutic target Relief of local symptoms Therapy recommendations Woman Woman: Careful local care of the labia majora and minora (labia) with dexpanthenol cream (also known as pantothenol, D-panthenol, or panthenol) [basic therapy]. Estrogen-containing (estriol-containing) hydrophilic creams – in early stages in women, especially younger women. Shock therapy Topical glucocorticosteroids (TGS): clobetasol propionate 0.5% for 2-3 … Lichen Sclerosus: Drug Therapy
Medical device diagnostics are not usually required. Medical device diagnostics are not usually required. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Uroflowmetry (urine flow measurement) – measurement of urine flow during bladder emptying to objectively determine … Lichen Sclerosus: Diagnostic Tests
1st order Circumcision (circumcision) in boys and men – this should be sought early! (best long-term success) 2nd order In women with extensive clinical symptoms, the following procedures are indicated: removal of skin findings by: Cryotherapy (icing), especially in the genital area – this leads to improvement of pruritus (itching) and sclerosis; the therapy is … Lichen Sclerosus: Surgical Therapy
Prevention of lichen sclerosus requires attention to reducing individual risk factors for triggering the disease. Behavioral risk factors for triggering the disease. Scratching/chafing effects due to too tight clothing. Medication Carbamazepine Imatinib Oral contraception (contraceptives taken by mouth (“per os”)) with antiandrogenic partial effect. Prevention factors (protective factors) Medications: ACE inhibitors, beta-blockers, hormone replacement therapy, … Lichen Sclerosus: Prevention
The following symptoms and complaints may indicate lichen sclerosus et atrophicus: Woman Symptoms in women (genitoanal range; approximately 90% of cases). Lichen sclerosus et atrophicans is found preferentially in the vulvar area (entirety of the external primary sex organs) in adult women: Erythema* (redness of the skin). Erythema with petechial hemorrhages* (flea-like bleeding). Brown-red discoloration … Lichen Sclerosus: Symptoms, Complaints, Signs
Pathogenesis (disease development) The exact cause of lichen sclerosus et atrophicus is unknown. Autoimmune processes, among others, are discussed, as is an infectious genesis (Borrelia, EBV, and wart infections). The presence of associated autoimmune diseases (e.g., autoimmune thyroid diseases) is also discussed. However, specific autoantibodies cannot be detected in lichen sclerosus patients. The development of … Lichen Sclerosus: Causes
Notice: Early diagnosis and thus effective initiation of therapy is important! General measures Cleaning and care of the intimate area Use little soaps when washing in the genital area. Mild substances should be used for washing; use neutral fat ointments in intervals without treatment. Several times daily application of emollients (bes. fatty ointments) and / … Lichen Sclerosus: Therapy
The medical history (history of the patient) represents an important component in the diagnosis of lichen sclerosus. Family history What is the general health of your relatives? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to … Lichen Sclerosus: Medical History
Skin and subcutaneous (L00-L99). Allergic contact dermatitis – skin change triggered by skin contact with certain substances. Eczema (here: genital eczema) – group of inflammatory skin diseases that manifest themselves in a non-infectious inflammatory reaction of the skin. Leukoplakia – cornification disorder of the mucous membranes as well as genitals. Lichen planus (LP) – T-cell-mediated … Lichen Sclerosus: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by lichen sclerosus: Skin and subcutaneous (L00-L99). Tearing/bleeding of the affected skin areas, e.g., due to scratching. Infectious and parasitic diseases (A00-B99). Infection of the affected areas of the skin Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Narrowing of … Lichen Sclerosus: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) of the skin and mucous membranes. Genitoanal area (90% of cases) [white, porcelain-like patches; vulnerable skin; frequently bleeding rhagades (fissures; narrow, cleft-like tear that cuts through all layers of … Lichen Sclerosus: Examination
