Lichen sclerosus: early diagnosis is the key to treatment.

Lichen sclerosus of the vulvar is an often misdiagnosed and chronic gynecologic disease. Women of any age can be affected, but it is most common in the perimenopausal and postmenopausal years. The treatment for lichen sclerosus is limited with no cure. The current treatment is a lifelong procedure and may not prevent the progression of the disease. The primary treatment for lichen sclerosus is testosterone ointment, which may cause unwanted side effects. Complications arising from vulvar lichen sclerosus include loss of vulvar structure and fusing of labia which causes covering of the clitoris. Vulvar lichen sclerosus may also cause painful intercourse and defecation. Due to the intense pruritus, excoriation of the area occurs. This information can help the clinician to detect the disease early and start treatment before serious complications begin. Diagnostic and treatment information is provided in this article to help the clinician understand the nature of this disease.