Can lichen sclerosus and atrophy be cured?

Lichen sclerosus atrophicus is a relatively common gynecological disease and one of the biggest killers of women's health. Lichen sclerosus is generally a disease caused by collagen fiber degeneration, and the incidence of this disease is relatively high in postmenopausal women. Of course, this disease is not without treatment. Below, we will introduce you to the relevant knowledge about lichen sclerosus and atrophy in detail!

1. Causes

This disease is a collagen fiber degeneration disease. Because the disease begins clinically in the form of white spots, it is also called white spot disease. It is a degenerative skin disease.

2. Clinical symptoms

It often occurs in elderly women after menopause, but can also occur in young girls aged 2-6 years old. It is more common in young and middle-aged men, and is more likely to occur in the penis area. In women, it is more common in the vulva and around the anus. The lesions are white or ivory. It starts as spots the size of rice grains, scattered and clustered. It is not hard at this time, but when it merges into patches, the skin becomes hard and lacks elasticity. In women, it occurs on the vulva and anus, appearing as ivory-white spots with unclear boundaries and a dumbbell-like distribution pattern. In men, it occurs on the glans penis or foreskin, and the hardening makes it difficult for the penis to erect. Eventually atrophy will occur. Squamous cell carcinoma occurs in approximately 10% of cases.

Prevention and treatment: Women should supplement some estrogen after menopause. For those who have already developed the disease, girls can apply 2%-3% testosterone propionate cream externally. Menopausal women experience severe itching, which can be easily misdiagnosed as leukoplakia of the vulva. Intralesional injection of triamcinolone acetate is effective, but the dosage should be smaller and the intervals should be longer.

Treatment

1. General treatment

Keep the vulva clean and dry, do not use irritating drugs or soaps to clean the vulva, avoid wearing synthetic underwear, and do not eat spicy or allergenic foods. For patients with severe itching symptoms leading to insomnia, sedatives, sleeping pills and anti-allergic drugs can be added.

2. Topical medication

The main symptom of this disease is severe itching, and the treatment with glucocorticoids has a definite effect. Commonly used: 1% to 2% hydrocortisone ointment or 0.025% fluocinolone ointment, 3 to 4 times a day. Six weeks after medication, the skin lesions will return to normal. Topical application of testosterone propionate is the standard method for treating lichen sclerosus. The efficacy varies from person to person. Some atrophic skin can return to normal, some lesions can improve, and some have no obvious effect.

3. Subcutaneous Injection

For patients with persistent itching and ineffective topical medications, subcutaneous injection of triamcinolone acetonide suspension can be used. If this method does not achieve the desired effect and the patient still has itching, pure alcohol can be injected subcutaneously under regional anesthesia. Care should be taken not to inject alcohol into the skin, as this will cause skin necrosis. Subcutaneous injection of alcohol can completely relieve itching, but it cannot relieve the burning sensation of the vulvar skin.

4. Surgery

For patients with severe conditions or who are unresponsive to drug treatment, superficial vulvar excision or laser excision can be performed. Laser excision can only remove epidermal lesions but is ineffective for dermal lesions under the epidermis. The recurrence rate of surgical excision is high, not only at the excision edge but even in transplanted skin. The disease has a very small chance of becoming malignant and surgical treatment is rarely used.