About Lichen Sclerosus – LS-BioScience

WHAT IS LICHEN
SCLEROSUS

LICHEN SCLEROSUS IS A PAINFUL CHRONIC PROGRESSIVE INFLAMMATORY DERMATOLOGIC CONDITION

Lichen Sclerosus (LS) is a chronic, inflammatory, cutaneous disorder, resulting in skin scarring, sexual pain, and even squamous cell carcinoma (SCC). While LS lesions may develop over any cutaneous tissue at any age in both sexes, there is a predilection for anogenital skin in 85%-98% of cases, with a higher incidence of onset among pre-menarche and post-menopausal females.

Although LS is seen as a rare condition, it is among one of the most common referrals for vulvar pruritus and is the most common form of structural change to the vulvar region.

Common Symptoms

LS diagnosis on average takes 6 months. This is due to physician under-recognition and misdiagnosis, LS management under different specialties, and asymptomatic cases.

Patchy lesions that coalesce into sclerotic plaques
Intolerable pruritus and burning
Tissue scarring and tearing
Drastic changes to genital anatomy
Sensations similar to chronic urinary tract and yeast infections

Severe outcomes of decease progression

Developing lesions lead to vulvar pain and sexual dysfunction, with a significant loss of structural anatomical architecture, sclerosis, and increased risk of malignancy

Fusing of the labia and clitoral hood
Urinary and sexual dysfunction
Elevated risk of developing squamous cell carcinoma
Big impact on relationship with partner
Strong depression and suicidal thoughts

Potential causes

Despite the strong association with autoimmune disease, the etiology of LS remains a large mystery.

Genetic evidence for heredity: 12% of female LS patients had a first-degree female relative also diagnosed with LS
Autoimmune Association: ~30% of LS women have comorbidity with at least one other autoimmune disease
Trauma-induced component: a lot of women report onset of LS after giving birth vaginally or after medical interventions to the area

First line treatments

Although there is no cure for LS, there are a number of treatment options that have been explored to achieve remission and prevent progression of disease.

Ultrapotent Topical Corticosteroids: The gold standard treatment, most commonly clobetasol propionate ointment.
Topical Calcineurin Inhibitors: tacrolimus, and pimecrolimus, which block the release of inflammatory cytokines from T lymphocytes, can be used as alternatives to corticosteroids.
Platelet-Rich Plasma promotes the healing process of tissue by stimulating the release of cytokines and growth factors.
Energy-Based Modalities: photodynamic therapy (PDT), High-Intensity Focused Ultrasound (HIFU), and fractional CO2 lasers (FxCO2)

Pathological schema of LS
with potential immune and genetic targets

Here you can read more about Lichen Sclerosus and its current perspectives

WHAT IS LICHENSCLEROSUS