Definition:
LSA or lichen sclerosus et atrophicus is a disease with no known pathogenesis that severely impacts the afflicted patient's quality of life.
Approximately 14 individuals per 100,000 people are affected by LSA per year. Females have a predilection for the disease. Fifteen percent of cases involved patients 10 to 30 years old.
Diagnosis:
In diagnosis of LSA, CD8/CD57-positive epidermotropic lymphocytes frequently serve as markers for a chronic deposition. Levels of intraepidermal major histocompatibility complex (MHC) class II–positive cells may also be elevated.
Treatment:
Extragenital LSA is generally asymptomatic and therefore requires little or no treatment.
Symptomatic LSA is more difficult to treat, as no medication has been proven to be completely successful. To date, the only treatment with recorded efficacy in long-term therapy is topical steroids.
Though painful and intrusive, photodynamic therapy is sometimes required if squamous cell cancer is suspected.
Symptoms and Signs:
LSA often presents with pain in the anogenital area (penis, vulva, and rectum). However, any skin site may be affected.
LSA is most commonly documented as occurring on the vulva. Some patients are asymptomatic, while others complain of soreness and stubborn itching.
LSA can progress to destructive sclerosis, eventually leading to a narrowing of the anogenital orifices.
Extragenital areas may also be affected, including the thighs, chest, neck, shoulders, and sometimes even the oral mucosa.
Causes:
Although no specific cause has been identified to date, LSA is often associated with alopecia areata, vitiligo, as well as clinical and serologic disorders of the thyroid.
In experimental research, it has been revealed that antibodies are present in the extra-cellular matrix (ECM) protein of afflicted patients. This finding seems to indicate an autoimmune origin for the disease.
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