Lichen Sclerosus

Notable Vulvar Irritation and Dyspigmentation

Abstract

Lichen sclerosus is a chronic inflammatory condition characterized by irritation and dyspigmentation in the genital and perianal areas. Although this condition can affect any individual, it typically has a bimodal age distribution, occurring most frequently in postmenopausal women followed by prepubertal children. Physical examination often reveals thin, hypopigmented and hyperpigmented patches or plaques in the vulvar, perineal, or perianal region. The exact etiology of lichen sclerosus is unknown but is believed to be multifactorial with a combination of genetic, environmental, infectious, and autoimmune factors. Once diagnosed, this condition has a chronic course and long-term treatment is required to sustain remission. We present a case of lichen sclerosus involving the vulvar, perineal, and perianal regions in an elderly female patient that improved with topical clobetasol.