Lichen sclerosis lichen: how to overcome a serious disease?

Склероатрофический лишай: как побороть это тяжелое заболевание?Dear readers, our article will talk about severe disease, which is called lichen sclerosis lichen.

This pathology is not fully understood, experts identify several main reasons, which will be described above.

What is the disease?

Lychen lichen sclerosis refers to chronic diseases that affects the skin, causing irreversible changes in the form of atrophy.

Primarily affected the genitals, more common in women (about 10 times).

Other names of the disease: white spot disease, kraurosis of the penis-kraurosis vulvae, balanitis obliterans keramicheski.

Names usually vary depending on the location of the lesion. Thus, the gynecologists talk about the kraurosis of the vulva, urologists — sclerotic obliterans balanitis.

What triggered the disease?

Склероатрофический лишай: как побороть это тяжелое заболевание?Factors that can influence the development of the disease a few:

  • Genetic predisposition. Perhaps one of the main reasons family proven cases of sclerosing lichen the twins, mothers and daughters, sisters. The severity is directly dependent on the inheritance of several genes;
  • Autoimmune diseases. A number of studies have shown a link licena with such autoimmune diseases: alopecia, vitiligo, pernicious anemia, scar pemphigoid, psoriasis, diabetes, lupus, rheumatic polimialgia, primary biliary cirrhosis and many others;
  • Infection. Great importance is given to viruses and spirochetes. For example, Lyme disease is caused by spirochetes, the patient has acrodermatitis, all signs like Lychen lichen sclerosis. Viruses given role in the development of balanite, as they are often found in patients who had surgery, the circumcision because of the sclerosing balanite;
  • Local factors. In rare cases the doctors attribute the development of balanite with local damaging factors. For example, after irradiation, abrasions on the skin, chronic irritation of the foreskin the urine of patients with diabetes;
  • chronic irritation of the foreskin the urine of patients with diabetes;
  • The hormonal imbalance. A predisposing factor is impaired absorption of male hormones cells.
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    When it’s time to think about this disease?

    Склероатрофический лишай: как побороть это тяжелое заболевание?The disease is chronic for many years. Patients often do not seek help at the first spots.

    The eruption appears in waves, their number may increase and decrease. It is noteworthy that the girls often comes self-treatment.

    Sometimes the disease exists together with vitiligo and scleroderma, are also described cases of his rebirth into squamous cell carcinoma.

    Of the clinical variants of the disease describes two: with extragenital lesions of the skin of the body, genital with the capture of the skin and mucous membranes of the genitals.

    Less common extragenital form (approximately 20% of cases). In this case, a typical localization are: neck, armpits, the skin of the palms and soles, flexor side of the wrists, much less visible foci in the mucosa of the oral cavity.

    The rash of lichen lichen sclerosis appears as white spots or papules (shown in photo), sometimes they merge, forming large plaques.

    Initially, the rash is all on one level with the skin, but since the processes are dominated by atrophy, later the spots are below.

    In the Central part of the lesions you can see small holes. Surface stains may appear as warty as the mouth of the hair follicles and sweat glands are filled with Horny plugs.

    Склероатрофический лишай: как побороть это тяжелое заболевание?Lichen sclerosis lichen of the vulva is the most frequent form of the disease (genital its shape). Previously it was possible to meet the name of kraurosis vulva.

    Patients spots appear on the vulva, perineum, perianal skin folds, in the crotch.

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    Color spots — ivory, clear borders. The spots coalesce into large lesions. Some patients have telangiectasia, are bubbles with hemorrhagic content, erosion.

    After that, healing occurs with scarring and fusion of the labia minora. Perineal and vulvar rashes often resemble a figure eight or circle.

    The disease is complicated by the addition of a secondary bacterial infection, fungal flora. In patients of older age is more common lichen degeneration into squamous cell carcinoma.

    Put to your attention a themed video about the disease:

    In men, the disease is called lichen sclerosis lichen the penis. Some specialists refer to it keramicheski obliterans balanitis.

    Almost always observed disease in men without a circumcision. At the head of the penis appear spots or plaques of white color, later, you notice telangiectasia and erosion.

    If involved in the pathological process of periurethral tissue, develops a narrowing (stricture) of the urethra and loss of the foreskin leading to phimosis.

    Treatments

    Склероатрофический лишай: как побороть это тяжелое заболевание?The disease should be treated in the early stages, as it invariably leads to sclerosis and scarring, manifested in large problems.

    In severe cases, narrowing the urethra, violates the outflow of urine. If the normal dynamics of urine is disturbed, sooner or later, come to bacterial inflammatory diseases of organs located above (bladder, kidneys).

    Treatment lichen is mainly in the use of hormonal ointments, but sometimes surgery to repair large damaged areas.

    In men with lesions of the glans penis an operation is performed the circumcision.

    This is carried out in the first stage, sclerotic lichen provided that the glans and urethra is not affected.

    In the second stage affects the foreskin, glans penis, the process can go on the coronal sulcus and the skin of the head.

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    Склероатрофический лишай: как побороть это тяжелое заболевание?At this stage might involve the urethra, which is manifested by disorders of urination. Treated surgically widen the urethra, for a long course of prescribe corticosteroid ointment (Celestoderm, Diprospan, Akriderm).

    In the third stage, varies considerably in the form of the genital organs, so the treatment is to hold the plastic, removable urethral strictures, excision of scars, long-term appointment corticosteroid ointments.

    In the fourth stage perform a biopsy to rule out cancer. Treatment is surgical excision of the cicatricial tissue.

    Local drugs shall also be Tacrolimus, a calcineurin inhibitor. Side effect is the possibility of developing malignant tumors.

    Of non-pharmacological methods are used laser therapy, ultrasound, acupuncture and electrocoagulation.

    Remember that the disease is chronic, therefore, timely treatment for medical help will give best results of treatment and halt the disease at the time when there are no complications.

    Author: Anna Derbeneva (dermatologist)

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