Nair Pragya Ashok
Department of Dermatology and Venereology, Pramukshwami Medical College, Karamsad, Gujarat, India.
J Midlife Health. 2017 Apr-Jun;8(2):55-62. doi: 10.4103/jmh.JMH_13_17.
Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia, dysuria, and urinary or fecal incontinence. Anogenital lichen sclerosus (LS) is characterized by porcelain-white atrophic plaques, which may become confluent extending around the vulval and perianal skin in a figure of eight configuration. Thinning and shrinkage of the genital area make coitus, urination, and defecation painful. LS is not uncommon in India and present as an itchy vulvar dermatosis which a gynecologist may mistake for candidal vulvovaginitis. There is often a delay in diagnosis of VLS due to its asymptomatic nature and lack of awareness in patients as well as physicians. Embarrassment of patients due to private nature of the disease and failure to examine the genital skin properly are the other reasons for delay in diagnosis. There is no curative treatment for LS. Various medications available only relieve the symptoms. Chronic nature of the disease affects the quality of life. Proper and regular follow-up is required as there are chances of the development of squamous cell carcinoma.
外阴硬化性苔藓（VLS）是一种慢性炎症性皮肤病，其特征为表面发亮的乳白色斑块或斑片，通常累及外阴和肛门。常见症状包括瘙痒、疼痛、性交困难、排尿困难以及尿失禁或大便失禁。肛门生殖器硬化性苔藓（LS）的特征是瓷白色萎缩性斑块，这些斑块可能融合成片，呈“8”字形围绕外阴和肛周皮肤延伸。生殖器区域的变薄和萎缩使得性交、排尿和排便都很痛苦。LS在印度并不罕见，表现为一种瘙痒性外阴皮肤病，妇科医生可能会将其误诊为念珠菌性外阴阴道炎。由于VLS无症状的性质以及患者和医生对此缺乏认识，其诊断往往会延迟。由于疾病的隐私性导致患者尴尬以及未能正确检查生殖器皮肤，也是诊断延迟的其他原因。目前尚无治愈LS的方法。现有的各种药物只能缓解症状。这种疾病的慢性性质会影响生活质量。由于存在发展为鳞状细胞癌的可能性，因此需要进行适当且定期的随访。
