Lesiones ampollares en una paciente con morfea panesclerótica discapacitante de la infancia / Bullous lesions in a patient with panesclerotic morphea of the childhood

La morfea ampollar es un tipo enfrecente de esclerodermia localizada que se caracteriza por presentar ampollas sobre placas escleróticas. La presencia de este tipo de lesiones obliga a descartar la variante extraenital de liquen esclerodemias localizadas, es posible hallar ambas afecciones. Se describe el caso de una paciente de 19 años con diagnóstico de morfea panesclerótica y liquen escleroso ampollar.

Bollous morphea is an infreqent type of morphea characterized for developing bullae on sclerodermiformic plaques. The presence of bullae forces to discard lichen sclerosus, a disease that usually develops in the genital zone, the extragenital variant could belong to the same spectrum that localized sclerodermiformic diseases. We present a 19 year old female patient with the diagnosis of panesclerotic morphea and bullous lichen sclerosus.

Microablative fractional radiofrequency as a therapeutic option for vulvar lichen sclerosus: a pilot study

OBJECTIVES: To assess the clinical response to and the histomorphometric effects of microablative fractional radiofrequency (MFR) in women with symptomatic vulvar lichen sclerosus (VLS). METHODS: This was a pilot study on the use of MFR for the treatment of VLS. Upon recruitment and at each treatment session, all participants were examined and each of their symptoms were rated on a visual analog scale. After the procedure, the participants completed a satisfaction questionnaire. We compared the morphometric findings of vulvar biopsies performed at enrollment and after the last treatment session. The participants were divided into three groups according to previous treatment with corticosteroids: G1, no previous treatment; G2, treated for up to 5 years; and G3, treated for >5 years. RESULTS: This study included 26 women. After two to three sessions, most participants in all groups became either "asymptomatic" or "much better" than before treatment and were "very satisfied" or "satisfied" with the intervention. Pruritus and burning sensation were the most frequently reported symptoms. Nearly 40% of the participants in all groups reported complete remission of symptoms. The improvement was rated as moderate or higher by 80%, 76%, and 66% of the women in groups 1, 2, and 3, respectively. The improvement of symptoms persisted for 11 months (range, 7-16 months), on average, after the treatment. Type III collagen concentration significantly increased and was associated with important symptom improvement. Tissue trophism and vascularization also increased but did not reach statistical significance, probably because of the small number of cases. CONCLUSIONS: MFR may be an effective and safe treatment for symptomatic VLS.

Established Genital and Extragenital Lichen Sclerosus:A Clinicopathological Analysis / 中国医学科学院学报

Objective To investigate the clinicopathological characteristics of established genital and extragenital lichen sclerosus(LS)and compare the differences between them. Method The clinicopathological data of 55 patients with established genital and extragenital LS diagnosed by pathological examination in the Department of Dermatology of Beijing Hospital were retrospectively analyzed. Results The 55 patients included 11 males and 44 females.Among them,38,15,and 2 patients had genital lesions,extragenital lesions,and both genital and extragenital lesions,respectively.Extragenital LS mainly involved the back(14.55%)and extremities(7.27%).Among the patients,28.30% were asymptomatic,and 73.58% and 24.53% felt itchy and painful,respectively.The asymptomatic patients had a higher proportion in extragenital cases(

Balanopreputial Adhesion and Paraphimosis due to Lichen Sclerosus

No abstract available.

A Case of Nodular Lichen Sclerosus / 대한피부과학회지

No abstract available.

Extragenital Lichen Sclerosus Et Atrophicus along the Blaschko's Lines of the Forehead / 대한피부과학회지

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory dermatosis presenting as white papules and atrophic patches in the anogenital region. Extragenital LSA is rare and commonly affects the neck, thighs, and the trunk. A 68-year-old woman presented with a well-demarcated, whitish linear plaque on the forehead that was observed several months prior to presentation. A biopsy specimen showed hyperkeratosis and thinning of the epidermis and homogenization of collagen in the papillary dermis with a subepidermal cleft. Mild periappendageal lymphocytic infiltration and eccrine gland atrophy secondary to thickening of collagen bundles were observed in the deep dermis. Based on the clinical and histopathological findings, this patient was diagnosed with extragenital LSA and concomitant morphea along the Blaschko's lines.

Liquen escleroso genital y extragenital en la infancia: a propósito de un caso clínico / Lichen sclerosus in childhood

El liquen escleroso es una dermatosis inflamatoria crónica de piel y semimucosas que afecta princi-palmente vulva y región perianal, la localización extragenital vista sólo en 15 a 20% de los casos es rara en la infancia. La presentación más frecuente es la anogenital con pápulo-placas blanco marfil, atrofia, erosiones, púrpura y esclerosis. En mujeres afecta simétricamente zona interna de vulva, pe-rianal y periné adquiriendo forma típica en ocho, sin afectar vagina o himen. El liquen escleroso ex-tragenital se localiza principalmente en el dorso, cuello, periumbilical, muñecas y axilas con lesiones similares a las descriptas. Presentamos el caso clínico de una escolar de 11 años, sin patologías previas, que consulta por der-matosis situada en piel y mucosas topografiada en tronco y genitales. En piel, zona escapular bilate-ral, se observan placas blanco-nacaradas de cen-tro atrófico, sin esclerosis palpable. En mucosas, afectaba labios mayores, menores y zona perianal en forma de ocho, con atrofia y coloración blanco-brillosa. Refiere un año de evolución, con prurito vulvar y constipación. Se realiza diagnóstico de li-quen escleroso genital y extragenital y tratamiento con buena evolución.La importancia de conocer su diagnóstico radica en que es una patología que afecta la calidad de vida de los pacientes, por su sintomatología, su po-sible repercusión sexual y urinaria, y su potencial riesgo de carcinoma espinocelular. Es importante tener un alto índice de sospecha, ya que, debido a su baja frecuencia en la edad pediátrica, muchas veces el diagnóstico es tardío.

Lichen sclerosus is a chronic inflammatory der-matosis of skin and semi-mucosae, important for its sexual and urinary repercussion, and its poten-tial risk of squamous cell carcinoma.Mainly affects vulva and perianal region, extrage-nital localization seen only in 15 to 20% of cases is rare in childhood. The most frequent presenta-tion is anogenital with white ivory papule-plates, atrophy, erosions, purpura and sclerosis. In women it affects the inner area of the vulva, peria-nal and perineum, acquiring a typical shape in eight, without affecting the vagina or hymen. The extragenital sclerosus lichen is located mainly on the back, neck, periumbilical, wrists and armpits with lesions similar to those described.We present the case of a schoolgirl of 11 years, without previous pathologies, who consulted for dermatosis located on the skin and mucous mem-branes on the trunk and genitals. In skin, bilateral scapular area, white-nacreous plates of atrophic center are observed, without palpable sclerosis. In mucous membranes, it affected the labia mi-nora, majora and perianal zone in eight form, with atrophy and white-shiny coloration. She referred a year of evolution, with vulvar pruritus and constipation. Genital and extragenital lichen sclerosus diagnosis was made and had a good evolution with treatment.

Rejuvenation Using Platelet-rich Plasma and Lipofilling for Vaginal Atrophy and Lichen Sclerosus

Vaginal atrophy is a common condition among peri- and post-menopausal women. Symptoms of vaginal dryness, pruritus, irritation, loss of subcutaneous fat, sparse pubic hair and dyspareunia occur due to decreased estrogen level. Estrogen-based treatments are effective. But many patients are reluctant to be treated due to health concerns. As alternatives, we explored the efficacy of platelet-rich plasma (PRP) and lipofilling. A 67-year-old female patient with vaginal atrophy was referred to our department. Treatment using estrogen cream had failed to improve patient's symptoms. Diminished volume and aged look of genitalia were also major concerns. We treated her using lipofilling mixed with PRP. A total of 40 cc of autologous fat mixed with PRP was transferred to labia majora. Lipofilling with PRP relieved the clinical symptoms. Missing fullness and tone was corrected and the augmented volume was well maintained. White patchy lesions of lichen sclerosus on labia minora also improved. Lipofilling with PRP relieved symptoms, restored contour of the labia majora and achieved remission of lichen sclerosus on labia minora. As vulvar lesions were repaired and the aged appearance of genitalia was rejuvenated, both functional and cosmetic outcomes were satisfactory. Lipofilling with PRP can be effective for vaginal atrophy and lichen sclerosus.

Extensive bullous lichen sclerosus et atrophicus

Abstract Lichen sclerosus et atrophicus is a chronic disease of unknown etiology characterized by atrophic and sclerotic plaques in both genital and extragenital regions. Extensive bullous lichen sclerosus et atrophicus (BLSA) is a severe variant of the disease with no widely accepted treatment. We present a 63-year-old woman with extensive extragenital, ivory-colored, atrophic plaques on her trunk and extremities and disseminated hemorrhagic bullae. The patient was unsuccessfully treated with standard topical corticosteroid therapy, doxycycline and chloroquine. According to the literature, there is little evidence of the efficacy of doxycycline and hydroxychloroquine in the treatment of BLSA. We report a rare case of extensive BLSA that is unresponsive to these drugs.

Lichen sclerosus associated with localized scleroderma: dermoscopy contribution

Abstract: Lichen sclerosus is an uncommon inflammatory dermatosis with preferential involvement of the urogenital region. The extragenital involvement is uncommon and is characterized by small rounded macules or papules, pearly white in color. The coexistence of lichen sclerosus and scleroderma plaques in most cases with extragenital location has been reported in the literature. We report a case of lichen sclerosus associated with scleroderma in children, highlighting the importance of dermoscopy in diagnosis.

Liquen esclero atrófico extragenital / Extra-Genital Atrophic Lichen Sclerosus

El Liquen esclero atrófico es una enfermedad inflamatoria crónica de la piel que afecta la epidermis y la dermis, la causa es desconocida, aunque se considera que la génesis es multifactorial. Los principales factores con los que se ha relacionado, incluyen los genéticos, inmunológicos, infecciosos, traumáticos y hormonales. Se presenta el caso de un paciente masculino de 24 años de edad con diagnóstico de Liquen esclero atrófico extra genital, con antecedentes de asma bronquial desde la infancia, hace 5 años presenta múltiples lesiones en placas acrómicas, de aspecto nacarado, algunas atróficas en su región central, asintomáticas(AU)

Atrophic Lichen Sclerosus is a chronic inflammatory disease of the skin that affects the epidermis and dermis, the cause is unknown, although the genesis is considered to be multifactorial. The main associated factors have been genetic, immunological, infectious, traumatic and hormonal. A case of a 24-year-old male patient is presented here. He has a diagnosis of extra-genital atrophic lichen sclerosus, with a history of bronchial asthma since infancy. For 5 years, this patient has multiple lesions on acrylic plaques, pearly in appearance, some atrophic in the central region, asymptomatic(AU)

Pathological investigation of childhood foreskin: are lichen sclerosus and phimosis common?

Objective: To evaluate histopathological results of foreskin removed during circumcision in the pediatric age group and the relationship between these and the degree of phimosis

Study Design: Cross-sectional study

Place and Duration of Study: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey, from June to December 2014

Methodology: Male children undergoing planned circumcision were examined for the presence and degree of phimosis which was recorded before the operation. After circumcision, the preputial skin was dermatopathologically investigated. Pathological investigation carefully evaluated findings such as acute inflammation, chronic inflammation, increased pigmentation and atrophy in addition to findings of Lichen Sclerosus [LS] in all specimens. The pathological findings obtained were classified by degree of phimosis and evaluated

Results: The average age of the 140 children was 6.58 +/- 2.35 years. While 61 [43.6%] children did not have phimosis, 79 [56.4%] patients had different degrees of phimosis. Classic LS was not identified in any patient. In a total of 14 [10%] children, early period findings of LS were discovered. The frequency of LS with phimosis was 12.6%, without phimosis was 6.5% [p=0.39]. The incidence of histopathologically normal skin in non-phimosis and phimosis groups was 37.7% and 22.7%, respectively. In total, 41 [29.3%] of the 140 cases had totally normal foreskin

Conclusion: Important dermatoses such as LS may be observed in foreskin with or without phimosis. The presence of phimosis may be an aggravating factor in the incidence of these dermatoses

Liquen escleroso extragenital: Presentación de un caso / Lichen scleros extragenital: presentation of a case

El liquen escleroso es una enfermedad crónica inflamatoria de causa desconocida. En hombres su presentación es infrecuente y se observa más comúnmente en la cuarta década de la vida. Asimismo, las lesiones extragenitales son inusuales y asientan más comúnmente en extremidades y tronco. A continuación, presentamos un paciente de sexo masculino adolescente con diagnóstico de liquen escleroso en dorso

Lichen sclerosus is a chronic inflammatory disease of unknown etiology. Appearance in men is unusual and is most seen at fourth decade of life. Also extragenital lesions are rare and most commonly settle in extremities and trunk. A case of a male adolescent patient with lichen sclerosus in trunk is reported.

Bullous and hemorrhagic lichen sclerosus - Case report

Lichen sclerosus is a chronic inflammatory disease, usually located in the genital area. The etiology of lichen sclerosus is multifactorial, with participation of genetic, autoimmune, infectious and hormonal factors. Bullous clinical form stems from hydropic degeneration of the basal membrane, constituting a less frequent variant of the disease. In this work, we report the case of a female patient, 55 years old, who in the last three years presented whitish plaques, with horny spikes, located on back and arms. Some of these lesions evolved with hemorrhagic blisters, which after histopathological examination confirmed the diagnosis of bullous and hemorrhagic lichen sclerosus. The patient was treated with high-potency topical corticosteroid for two months, resulting in remission of bullous and hemorrhagic lesions.

Líquen escleroso hemorrágico extragenital / Lichen sclerosus hemorrhagic extragenital

Contexto: Líquen escleroso é uma doença crônica que se apresenta clinicamente na forma genital e, mais raramente, extragenital. Acometepreferencialmente as mulheres, e, em menor frequência, os homens. Sua etiologia permanece desconhecida; postula-se a associação com doenças autoimunes, predisposição genética, além de envolvimento de fatores hormonais e a importância do estresse oxidativo na gênese da doença. O tratamento de eleição é a corticoterapia tópica de alta potência com excelentes resultados, sendo utilizados ainda imunomoduladores, retinoides, progesterona e estrógeno, além de laser de CO2 e fototerapia. Relato de caso: Descrevemos um caso raro e excêntrico de líquen escleroso hemorrágico de apresentação incomum. Conclusão: Acentuamos a importância do diagnóstico clínico e histológico de forma exuberante desta dermatose, resolvida com sucesso.

Perineostomy: the last oportunity

Objective To review the technique and outcome of perineal urethrostomy or urethral perineostomy and to identify factors related to the procedure failure. Material and methods We studied 17 patients who underwent perineal urethrostomy between 2009-2013 in a single hospital. Success was defined as no need for additional surgical treatment or urethral dilatation. We reviewed the clinical data related to age, weight, previous urethral surgery, diabetes, hypertension, ischemic cardiopathy, lichen sclerosus and other causes and studied their association with the procedure failure (univariate analysis). We completed the analysis with a multivariate test based on binary regression. Results The average follow-up was 39.41 months. From all the causes, we found Lichen Sclerosus in 35%, idiopathic etiology in 29% and prior hypospadia repair in 18%. Postoperative failure occurred in 3 patients, with a final success of 82.4%. The binary regression model showed as independent risk factors ischemic cardiopathy (OR: 2.34), and the presence of Lichen Sclerosis (OR: 3.21). Conclusions The success rate with the perineal urethrostomy technique shows it to be a valid option above all when we preserve the urethral blood supply and plate. Lichen sclerosus and ischemic vascular problems are risk factors to re-stenosis. .

A Case of Lichen Sclerosus et Atrophicus Mimicking Xanthoma / 대한피부과학회지

No abstract available.

Synchronous Onset of Symmetrically Associated Extragenital Lichen Sclerosus and Vitiligo on both Breasts and the Vulva

No abstract available.

O tratamento bem-sucedido com fototerapia UVB banda estreita em um caso raro de líquen escleroso extragenital generalizado / Successful treatment of a rare case of widespread extragenital lichen sclerosus with narrow band UVB phototherapy

O líquen escleroso é patologia incomum acometendo tanto região genital quanto extragenital, constituindo apresentação atípica da doença. O uso de corticosteroides tópicos é considerado primeira linha para tratamento da doença genital. Lesões extragenitais são menos sensíveis a essa terapêutica. Relata-se caso de líquen escleroso em paciente do sexo feminino, de 82 anos, com envolvimento extragenital generalizado e tratamento bem-sucedido com fototerapia UVB de banda estreita. O líquen escleroso é dermatose inflamatória crônica, e as formas disseminadas da doença são raras e sem consenso em relação ao tratamento da forma extragenital. A opção pela terapia com UVB de banda estreita baseou-se nos relatos da literatura.

Lichen sclerosus is an uncommon condition affecting both the genital and extragenital region, the latter constituting an atypical occurrence of the disorder. The use of topical corticosteroids is considered the first-line treatment of this genital disease. Extragenital lesions are less sensitive to this therapy. The present study describes a case of lichen sclerosus in an 82-year-old female patient, with widespread extragenital involvement and successful treatment with narrow band UVB phototherapy. Lichen sclerosus is a chronic inflammatory dermatosis and disseminated forms of the condition are rare, with an absence of consensus on the treatment of the extragenital form. The choice for narrow band UVB therapy was based on the literature.

Liquen escleroso y atrófico: revisión de una dermatosis con múltiples manifestaciones / Lichen sclerosus and atrophic: review of a dermatosis with multiple manifestations

El liquen escleroso y atrófico (LEA) es una enfermedad inflamatoria crónica poco frecuente, de causa desconocida, con tendencia a la atrofia epidérmica y cicatrización destructiva. Predomina en mujeres, en la región anogenital, asociándose a un importante deterioro funcional y, en ocasiones, transformación maligna a carcinoma espinocelular. El tratamiento de elección es aún controvertido, siendo los corticoides tópicos de alta potencia y los inhibidores tópicos de la calcineurina los más utilizados. Se presentan cuatro casos clínicos de LEA; uno en una niña de 8 años, con una placa blanquecina atrófica localizada en tórax anterior; un segundo caso, un paciente de sexo masculino de 31 años con una placa blanquecina atrófica localizada en el glande, prepucio y cuerpo del pene; un tercer caso, un paciente de sexo masculino de 24 años con pápulas blanquecinas de 1 mm de diámetro, localizadas en el cuerpo del pene; y finalmente, una paciente de sexo femenino de 53 años con placas blanquecinas, atróficas e induradas en la axila derecha. Todos con hallazgos histopatológicos característicos que permitieron confirmar el diagnóstico de LEA. A partir de estos casos destacamos las diferentes localizaciones y edades de presentación que puede tener esta enfermedad junto con la importancia de un diagnóstico e inicio precoz del tratamiento. Esta revisión tiene como objetivo actualizar los conocimientos sobre los datos demográficos, clínicos, fisiopatológicos y terapéuticos en torno a LEA. Para ello, se realizó una búsqueda exhaustiva de la literatura utilizando los buscadores de PubMed y la Colaboración Cochrane. Resultados de la búsqueda incluyen bibliografía publicada hasta julio de 2014.

Lichen sclerosus et atrophicus (LSA) is an uncommon chronic inflammatory disease of unknown cause, prone to produce epidermal atrophy and destructive scarring. It predominates in women, in the anogenital region, usually associated with significant functional impairment and sometimes malignant transformation to squamous cell carcinoma (SCC). The treatment of choice is still controversial, with topical high potency steroids and topical calcineurin inhibitors being actually the most used. Four clinical cases are presented: one from an 8 year-old girl with a whitish atrophic plaque located on the chest; another is a male patient, aged 31, with a whitish atrophic plaque located on the glans, foreskin and body of the penis; a third case, 24 year-old male, with whitish papules of 1 mm in diameter located on the body of the penis and; finally, a female patient aged 53, with white atrophic and indurated plaques at the right axilla. All of them had characteristic histopathologic findings, confirming the diagnosis of LSA. From these cases we pretend to highlight the different locations and ages of presentation of LSA, and the importance of an early diagnosis and treatment. This review update the current understanding of the demographic, clinical, pathogenic and therapeutic data on LSA. For this, a comprehensive search of the literature was conducted using PubMed and Cochrane Library. Search results include published references until july 2014.