About guttate scleroderma, lichen sclerosus type

What is guttate scleroderma, lichen sclerosus type?

Lichen sclerosus is a chronic skin disorder that most commonly affects post-menopausal women. However, it is sometimes identified among pre-menopausal women, and, even more rarely, among males. When found in males, the disease is known as balanitis xerotica obliterans.

Lichen sclerosus is characterized by skin changes of the external genitalia (i.e., vulva, head of the penis), although other parts of the body may also be affected. Intense itching often accompanies attacks of lichen sclerosus. The disorder is not contagious nor is it a sexually transmitted disease. In the recent past, a genetic component for lichen sclerosus has been recognized. In addition, many clinical researchers believe that it is a disorder of the immunological system. The understanding of the causes of this disorder is still incomplete. Lichen sclerosus can develop concurrently with other conditions.

What are the symptoms for guttate scleroderma, lichen sclerosus type?

Lichen sclerosus is a rare skin condition characterized by white, Blotchy patches of skin.

Lichen sclerosus in genital area 

Lichen sclerosus may affect skin on any part of your body, but most often involves the skin of the vulva, foreskin of the penis or skin in the anal area.

People with mild lichen sclerosus may have no signs or symptoms.

Signs and symptoms usually affect the skin of the genital and anal areas, but may also affect the skin of the upper body, upper arms and breasts. They may include:

  • Redness
  • Itching (pruritus), which can be severe
  • Discomfort or pain
  • Smooth white patches on your skin
  • Blotchy, wrinkled patches
  • Tearing or bleeding
  • In severe cases, bleeding, Blistering or ulcerated sores
  • Painful sex

What are the causes for guttate scleroderma, lichen sclerosus type?

The cause of lichen sclerosus is unknown. An overactive immune system or an imbalance of hormones may play a role. Previous skin damage at a particular site on your skin may increase the likelihood of lichen sclerosus at that location.

Lichen sclerosus isn't contagious and cannot be spread through sexual intercourse.

Lichen sclerosus often occurs in postmenopausal women, but also in men and children. In women, lichen sclerosus usually involves the vulva. In boys and men, uncircumcised males are most at risk, because the condition generally affects the foreskin.

In children, the signs and symptoms may improve at puberty, but they will still need monitoring for disease activity.

What are the treatments for guttate scleroderma, lichen sclerosus type?

If you have lichen sclerosus on or around your genitals or anus, or have a more advanced case on other parts of your body, your doctor will recommend treatment. Treatment helps reduce itching, improve your skin's appearance and decrease further scarring. Recurrence is common. Rarely, lichen sclerosus gets better on its own.

Corticosteroids

Corticosteroid ointments or creams are commonly prescribed for lichen sclerosus. Initially, you'll generally have to use cortisone creams or ointments on the affected skin twice a day. After several weeks, your doctor will likely recommend that you only use these medications twice a week to prevent a recurrence.

Your doctor will monitor you for side effects associated with prolonged use of topical corticosteroids, such as further thinning of the skin.

Other treatment options

If corticosteroid treatment doesn't work or if months of corticosteroid therapy are needed, your doctor may prescribe an ointment such as tacrolimus (Protopic).

Removal of the foreskin (circumcision) in men is a common treatment in cases resistant to other therapies or more-advanced cases. Surgery in the genital or anal area generally isn't recommended for women with lichen sclerosus because the condition may just come back after surgery.

Ask your doctor how often you should return for follow-up exams. They are generally recommended every six to 12 months.

What are the risk factors for guttate scleroderma, lichen sclerosus type?

The risk of lichen sclerosus is higher for postmenopausal women, although it can occur in men and children. Men who are uncircumcised have a higher risk because the condition often affects the foreskin.

Is there a cure/medications for guttate scleroderma, lichen sclerosus type?

Guttate scleroderma is one of the abandoned names of a skin disease, currently called lichen sclerosis (LS). It is a chronic, inflammatory, mucocutaneous disorder of genital and extra-genital skin.

  • The exact etiology has not been established. Some of the causes include autoimmune abnormalities, genetic factors, hormonal influence, and infections.
  • In the early stages, symptoms include luminal hyperkeratosis and hypergranulosis of the adnexal structures.
  • Hyperkeratosis, epidermal atrophy with flattening of the rete ridges, vacuolar interface changes, loss of elastic fibers, and hyalinization of the lamina propria with underlying lymphocytic infiltrates are the classical symptoms of advanced LS.


Treatment

  • Topical corticosteroids are used to alleviate the symptoms, followed by maintenance therapy with emollients.
  • The topical calcineurin inhibitors (TCIs) including pimecrolimus and tacrolimus are better than corticosteroids as TCIs lack atrophogenicity.
  • Antihistamines at night may reduce itchiness.
  • Surgery

In women, LS may lead to introital stenosis that raises difficulties with micturition and sexual intercourse. The condition requires introital widening.
In men with LS, penile circumcision changes the local environment that enhances LS. Circumcision refers to the removal of the foreskin. Ventral meatotomy or dorsal V-mentoplasty corrects meatal stenosis.
Correction of urethral stenosis requires urethroplasty with buccal and/or bladder mucosa grafts.

  • Some lifestyles may help symptoms like avoiding harsh soaps and frequent bathing and maintaining skin moisture with creams.


Symptoms
Skin manifestation in genital and anal areas, upper body, breasts and upper arms,Redness,Itching (pruritus), which can be severe,Discomfort or pain,Smooth white patches on your skin,Blotchy, wrinkled patches,Tearing or bleeding
Conditions
Problems in the blood vessels, internal organs and digestive tract
Drugs
The topical calcineurin inhibitors (TCIs) including pimecrolimus and tacrolimus. Corticosteroids, antihistamines, and emollients

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