Lichen sclerosus and lichen planus are two chronic skin conditions within the category of vulvar lichen that primarily affect the genital and anal (perianal) areas.
However, lichen sclerosus tends to affect women more, while lichen planus can affect men (lichen sclerosus of the prepuce) and women equally.
Symptoms and characteristics of Vulvar Lichen Sclerosus
Vulvar Lichen Sclerosus is characterized by intense itching and signs such as white patches or plaques (hypopigmentation) on the skin, and may cause thinning (atrophic skin) and hardening of the genital skin, hence its former name of lichen sclerosus et atrophicus. Although it is most common in the genital and anal areas, it can also affect other parts of the body. Some women may experience pain during sexual intercourse or urination. In addition, lichen sclerosus can cause scarring and changes in the architecture of the vulva.
The exact origin or etiopathogenesis of Lichen Sclerosus is not yet known, but it is believed to be related to genetic factors, autoimmune issues, and environmental mechanisms (oxidative stress). Some risk factors for developing Lichen Sclerosus include a family history of the disease and certain autoimmune diseases.
Diagnosis of vulvar Lichen Sclerosus
The diagnosis of Lichen Sclerosus is usually made through a clinical evaluation, paying attention to morphological alterations along with the coexistence of symptoms such as itching, pain, and burning. Sometimes it is necessary to perform a skin biopsy. It is important to seek specialized medical care if lichen sclerosus is suspected, as early diagnosis can help prevent complications, improve treatment outcomes, and decrease the risk of vulvar squamous cell cancer.
Symptoms and Characteristics of Lichen Planus
Vulvar lichen planus is characterized by red or purplish skin lesions on the vulvar skin, which are often raised and may be itchy and painful, and may develop into vulvar erosive lichen planus. These clinical lesions can appear anywhere on the body, including mucous membranes such as the mouth and vagina. In some cases, lichen planus can cause manifestations in the form of blisters and painful ulcers.
The exact origin and prevalence of genital lichen planus is not fully understood, but it is believed that it may be an autoimmune reaction of the body. Lichen planus may also be related to genetic factors and triggers such as stress, certain medications, and viral diseases.
Diagnosis of genital lichen planus
Diagnosis of this disease is usually made by clinical evaluation and, in some cases, a skin biopsy or oral biopsy may be performed if mucous membranes are affected. It is important to seek specialized medical attention if lichen planus is suspected, as early diagnosis can help control symptoms and prevent complications.
Main differences between lichen sclerosus and lichen planus
Although lichen sclerosus and lichen planus share some similar symptoms, it is key to make a differential diagnosis between these two skin conditions.
In summary, lichen sclerosus and lichen planus are two chronic skin conditions that can cause similar symptoms but have distinct characteristics. If you experience symptoms such as intense itching or burning, skin changes, or abnormal lesions, it is important to seek specialized medical attention for an accurate diagnosis and appropriate treatment. With proper care and medical follow-up, it is possible to manage these skin disorders and improve quality of life.
The only book written for women with Lichen Sclerosus
If you are interested in learning more about VLS, we recommend the book “I have Vulvar Lichen Sclerosus, what do I do now?”. All proceeds go to the Nixarian Foundation, a foundation dedicated to helping women suffering from Vulvar Lichen Sclerosus.
To make it easier for you to differentiate between these two diseases, we provide a table with their differences below:
Lichen Sclerosus
Thin white plaques on the skin that may cause thinning and hardening of the skin.
Affects the vulvar and anal area (but usually does not manifest in the vaginal area).
More common in women.
Lichen Planus
Raised red or purplish lesions, often causing itching and pain.
Can appear anywhere on the body, including mucous membranes (such as the vagina and oral mucosa).
Can affect both men and women equally.
