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How to Identify Lichen Sclerosus


The symptoms of lichen sclerosus can vary, depending on the location and severity of the disease.
Early in lichen sclerosus, small, subtle white spots appear. These areas are usually slightly shiny and smooth. As time goes on, the spots develop into bigger patches and the skin surface becomes thinned and crinkled. As a result, the skin tears easily, and bright red or purple discoloration from bleeding inside the skin is common. In someone with severe lichen sclerosus symptoms, rubbing or bumping the skin can cause pain.
When lichen sclerosus occurs on parts of the body other than the genital area, most often, there are no symptoms other than itching.
Lichen sclerosus symptoms are usually the same in children and adults.
(Click Symptoms of Lichen Sclerosus for more information.)

Making a Diagnosis

In order to make a lichen sclerosus diagnosis, the healthcare provider will ask a number of questions about a person's medical history and will perform a physical exam, looking for signs and symptoms of the disease. He or she may also recommend certain tests and procedures.
Healthcare providers can diagnose lichen sclerosus in advanced cases just by looking at the skin. However, early or mild lichen sclerosus often requires a biopsy (removal and examination of a small sample of affected skin). Because other diseases of the genitals can look like lichen sclerosus, a biopsy is advised whenever the appearance of the skin is not typical of lichen sclerosus.
A number of other medical conditions can have symptoms similar to lichen sclerosus. Before the healthcare provider makes a diagnosis, he or she will consider these other possible conditions, including:
  • Psoriasis
  • Discoid systemic lupus erythematosus (SLE or lupus)
  • Cicatricial pemphigoid
  • Hidradenitis suppurativa
  • Vitiligo
  • Scleroderma
  • Lichen simplex chronicus.

Information on Lichen Sclerosus

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