Early Lichen Sclerosus

• Young woman with slight itching not relieved by clotrimazole. Constantly being diagnosed as ‘thrush’.

• Sometimes clotrimazole HC helps temporarily helps.

• Vulval examination is warranted initially and when ‘thrush’ treatment is not going to plan

• Very subtle LS changes seen – labia minora slight resorption and characteristic ‘crease’ line where fusion occurring

Lady in her early 70's with vulval problems for years. Lichen Sclerosus was initially suspected and she was given Dermovate. She was later seen in Dermatology and had a biopsy done which did not confirm LS histologically so Dermovate was rarely used after that. Images today show total labial resorption. There are only the fissures where labia used to be. She needs continuous Dermovate. Luckily there is very little introital narrowing and hardly any excoriation.

Treatment

• See pdf of article on LS by Yesudian, O’Mahony et al. Also BAD patient leaflet.

• Dermovate ointment (adheres better than cream)

• Sensilube and or Millennium glide (silicone based lube also protects)

• Regular review