British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018

Lewis, Fiona M.; Tatnall, F.M.; Velangi, Shireen; Bunker, C.B.; Kumar, Amit; Brackenbury, F.; Mustapa, M.F. Mohd; Exton, L.S.; McHenry, P.; Leslie, Tabi A.; Wakelin, S. H.; Hunasehally, R.Y.P.; Cork, Michael J.; Johnston, Graham A.R.; Chiang, N.; Worsnop, Fiona; Buckley, David; Petrof, Gabriela; Salin, A.; Callachand, N.; Saunders, Clare; Salad, A.A.

doi:10.1111/bjd.16241

Cited by 237 publications

(193 citation statements)

References 109 publications

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“…Patients may be asymptomatic or report itch, dyspareunia, and poor urinary stream. Genital skin may have atrophic scarring with a “cigarette paper” appearance, which can extend to the perianal area with a classic “figure of eight” distribution39 (fig 3). Severe lichen sclerosus can result in loss of architecture with clitoral resorption, fissuring, and erosions.…”

Section: What Are Common Dermatological Causes Of Vulvar Itch?mentioning

confidence: 99%

“…Involvement of the vagina excludes lichen sclerosus 3. Left untreated, patients may develop scarring and possible malignant change to squamous cell carcinoma 39…”

Section: What Are Common Dermatological Causes Of Vulvar Itch?mentioning

confidence: 99%

“…The infographic (fig 6) summarises treatment options and the level of evidence for these. Expert committees recommend potent to very potent topical corticosteroid ointment in persistent cases of eczema and in seborrhoeic dermatitis, genital psoriasis, lichen planus, and lichen sclerosus 38913. These are to be applied daily for 4-8 weeks until symptoms are controlled.…”

Section: How Is It Treated?mentioning

confidence: 99%

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Vulvar itch

Alani

McDonald

Abdelrahman

et al. 2019

BMJ

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Section: What Are Common Dermatological Causes Of Vulvar Itch?mentioning

confidence: 99%

“…Involvement of the vagina excludes lichen sclerosus 3. Left untreated, patients may develop scarring and possible malignant change to squamous cell carcinoma 39…”

Section: What Are Common Dermatological Causes Of Vulvar Itch?mentioning

confidence: 99%

Section: How Is It Treated?mentioning

confidence: 99%

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Vulvar itch

Alani

McDonald

Abdelrahman

et al. 2019

BMJ

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“…Daily use of potent topical corticosteroids (TCS) is the recommended first‐line therapy for BXO in adult males and boys, for example, one fingertip unit of 0.05% clobetasol propionate ointment, as per the British Association of Dermatology (BAD) guidelines . Patients should promptly be referred to a dermatologist and urologist in the event of urinary symptoms.…”

Section: Treatmentmentioning

confidence: 99%

Balanitis xerotica obliterans: a review of diagnosis and management

Charlton

Smith

2018

Int J Dermatology

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Balanitis xerotica obliterans (BXO), or penile lichen sclerosus, is a progressive sclerosing inflammatory dermatosis of the glans penis and foreskin. It is associated with significant morbidity and may result in impaired urinary and sexual function. It was initially described by Stuhmer in 1928, named after its pathological features, and is considered the male equivalent of vulvar lichen sclerosis (LS).3,40 The etiology of BXO is uncertain; however, autoimmune disease, local trauma, and genetic and infective causes have been proposed. BXO occurs most commonly on the prepuce and glans penis. It is considered to have premalignant potential to transform into squamous neoplasia. This postulation rests on retrospective studies and parallels drawn with vulvar LS and squamous cell carcinoma (SCC) development. Histologically, BXO and vulvar LS are considered the same disease.41 There is a paucity of evidence‐based guidelines to assist with appropriate follow‐up for patients with BXO.

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“…Current guidelines suggest ultrapotent topical corticosteroids as first‐line treatment in MGLSc, although there are no randomized controlled trials to establish the ideal frequency or duration. Surgical treatment, cryotherapy, ultraviolet phototherapy, carbon dioxide laser and pulsed dye laser have also been used, with variable success . Recurrences after circumcision or in cases where long‐term use of steroids has resulted in adverse events are even more difficult to manage.…”

mentioning

confidence: 99%