Lichen sclerosus: causes, diagnosis and treatment

Authors of the article: Candidate of Medical Sciences O.Yu. Ermolaev

Gynecologist, physiotherapist-resortologist E.K. Ermolaeva
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Lichen sclerosus is a gross keratinization and atrophy of the skin and mucous membrane of the bunions. floor. organs.

Lichen sclerosus is manifested by atrophy (thinning) and sclerotic changes (wrinkling) of the labia majora and minora, and the clitoris.

With lichen sclerosus, sexual intercourse, urination, and defecation are DIFFICULT, which makes the treatment of lichen socially significant.

• STAGE 1 - itching, swelling, hyperemia (redness) of the external genitalia, dry skin and the appearance of microcracks in the skin, decreased sensitivity of the external genitalia (clitoris, labia majora) and the entrance to the vagina.

Photo of lichen sclerosus, stage 1. The mucous membrane of the labia minora is thinned, dry, with microcracks

• STAGE 2 - atrophy (flattening) and thickening (decreased elasticity) of the labia majora and minora, atrophy of the clitoris, narrowing of the vaginal opening, whitish (pale) color of the skin and mucous membrane of the vulva, coarsening of the skin and mucous membrane of the external genitalia, appearance on the skin depigmented areas of the vulva (areas with a lack of pigmentation) and/or pigment spots of various sizes and shapes, a significant decrease in the sensitivity of the vulva (clitoris, labia majora and minora), the entrance to the vagina, a decrease in the hair of the external genitalia. Sexual intercourse becomes painful and requires volitional efforts.

Photo of lichen sclerosus, stage 2. Atrophy (flattening) of the labia majora and minora, pale color of the skin and mucous membrane of the vulva, narrowing of the vaginal opening, reduction of hair

• STAGE 3 (sclerotic) - complete atrophy and sclerosis (wrinkling, “drying”) of the external genitalia: pubic hair is scanty or absent; the skin and mucous membrane of the vulva looks like a crumpled parchment sheet. Against the background of thinning and loss of elasticity of the skin, deep, poorly epithelized (“healing”) cracks and erosions (ulcers), almost complete loss of sensitivity of the vulva, narrowing and sclerosis (roughening) of the vaginal opening often occur. In some cases, complete closure of the vaginal opening is possible. Every sexual intercourse becomes a “test of feelings”, when “it is impossible to refuse, and it is impossible to agree.” After sexual intercourse, desquamation of the vulva and perineum (focal and/or generalized exfoliation of the skin of the external genitalia and perineum), the appearance of single or multiple microcracks, bleeding wounds and erosions (ulcers) are often observed. Desquamated areas (areas with no skin) are very painful, poorly epithelialized (impossible to heal) against the background of antibiotic therapy and traditional conservative treatment. Maintaining the strength of “family ties” requires incredible, sometimes heroic efforts from a woman, bordering on self-denial.

Photo of lichen sclerosus, stage 3. Thinning and loss of elasticity of the skin, wrinkling of the external genitalia, clitoral atrophy, narrowing and sclerosis of the vaginal opening, multiple microcracks in the skin

See all photos of lichen sclerosus

Pay ATTENTION to the excellent quality of the photographs, testifying to the expert class of colposcopes of the Women's Health Resort Clinic.

You can find photos of lichen sclerosus taken by our EXPERIENCED specialists in the treatment of lichen sclerosus on many Russian and foreign websites and in textbooks.

Lichen sclerosus does not prevent the onset and pregnancy of pregnancy.

The condition of the VULVA and perineum EVEN SOMETHING IMPROVES during pregnancy. However, the high RISK OF MATERNAL INJURY in the form of deep cracks and ruptures of the vagina, vulva and perineum inclines towards delivery by Caesarean Section.

Lichen sclerosus occurs more often in menopause and very rarely in young women, usually after extirpation (removal) of the ovaries.

Lichen sclerosus is NOT SEXUALLY TRANSMITTED, that is, it is not contagious.

• Causes of lichen sclerosus
• Prognosis for lichen sclerosus
• Diagnosis of lichen sclerosus
• Reasonable restrictions for lichen sclerosus
• Photos of the stages of lichen sclerosus

Treatment by appointment via multi-channel telephone number 8 (calls within Russia are free), or (for foreign calls).

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Causes of lichen sclerosus

The causes of Lichen sclerosus are considered to be neuroendocrine, immune and metabolic disorders.

In some cases, the cause (impetus for the development) of lichen sclerosus is a single or chronic (i.e. regular) CHEMICAL BURN when used for hygienic or contraceptive (contraceptive) purposes a solution of potassium permanganate (“potassium permanganate”), washing powders, brines, alcohol and etc.

We consider lichen sclerosus as a manifestation of spiritual and emotional disturbance, disagreement with Self and unreasonable CONTRASTING oneself to a man, circumstances and the surrounding reality.

According to research by gynecologists-endocrinologists at the Women's Health Resort Clinic, in most cases, the psychological factors predisposing to the development of lichen sclerosus are a STATE OF DESPONDERNESS, deep internal depression (depression), prolonged disappointment and SELF-UNACCEPTANCE, which are based on distrust, rejection and DENIAL OF A MAN and his feminine started.

However, in each specific case it is rarely possible to establish an unambiguous and unique cause of lichen sclerosus.

Efficiency

The effectiveness of treatment methods will depend on the patient and the duration of the disease. The sooner a woman seeks help, the faster the recovery will go. During therapy, be sure to follow the basic rules:

• tune in to constant hygiene, without soap - with a herbal solution;
• wear comfortable cotton underwear;
• give up intimacy;
• at night, use a light blanket;
• exclude spicy and fatty foods from your diet;
• do physical therapy exercises if your doctor advises;
• take walks before bed.

Gradually you will rehabilitate your intimate life, which is important. The main thing is to listen to your gynecologist. And you will get better quickly.

Prognosis for lichen sclerosus

Lichen sclerosus is a PRIMARY CHRONIC DISEASE with an imperceptible period of formation and a long course.

In most cases, lichen is incurable and SLOWLY PROGRESSES throughout life, BECAUSE most women categorically DO NOT WANT TO RETHINK themselves and look at life and themselves in this life in a new way.

Based on our long and successful experience in the treatment of lichen sclerosus, after eliminating the causes of lichen sclerosus and adequate comprehensive treatment, it is POSSIBLE to achieve and MAINTAIN a state of stable remission (a state WITHOUT COMPLAINTS and subjective changes).

Material and methods

In the clinic of skin and venereal diseases named after. V.A. Rakhmanov, for the period from 2022 to 2022, we examined 104 patients with an established diagnosis of OS (plaque scleroderma, linear scleroderma, LS, Pasini-Pierini atrophoderma). Of these, 86 were women (82.7%) and 18 men (10.5%). The age distribution of the patients was as follows: from 20 to 30 years - 18 people (17.3%), from 31 to 40 years - 18 (17.3%), from 41 to 50 years - 13 (12.5% ), from 51 to 60 years old - 26 (25%), from 61 to 70 years old - 23 (22.1%), from 71 years old and older - 6 (5.8%).

When conducting clinical and morphological phenotyping of all patients (n=104), we selected 62 patients with scleroatrophic lesions of anogenital localization.

Diagnosis of lichen sclerosus

• COLPOSCOPY is a painless examination using a colposcope, a special microscope for examining the cervix, vagina and vulva. About colposcopy in detail...
• BIOPSY - collection of a piece (fragment) of suspicious tissue followed by histological examination of biological material (microscopic examination of the structure of the skin and mucous membrane). At the Women's Health Resort Clinic, a biopsy is performed WITHOUT PAIN using a non-contact method, which meets modern world standards and is a LOW-TRAUMATIC procedure. About the contactless method in detail...
• MICROSCOPIC STUDY of the flora of a smear from the urethra, cervix and vagina.
• LIQUID CYTOLOGICAL STUDY of smears and scrapings of the cervix and cervical canal for atypical cells.
• Clinical blood test, immunogram.
• PSYCHOMETRIC TESTING allows us to identify the underlying psychological causes of lichen.

At the Women's Health Resort Clinic you can perform an ACCURATE diagnosis in order to identify lichen or refute the diagnosis of lichen.

*The cost of treatment is current since the last update of the price list (May 2022).

Reasonable restrictions for lichen sclerosus

Lichen sclerosus requires simple but important restrictions even after achieving remission during treatment at the Women's Health Resort Clinic.

If you have lichen, it is EXTREMELY UNDESIRABLE to take hot general baths, stay in the sun for a long time and sunbathe (regardless of the activity of the Sun, the presence/absence and type of bathing suit).

Thermal procedures and insolation (sunbathing in natural conditions and solariums) increases the production of estrogens (female sex hormones), the excess of which stimulates oncological processes.

Reviews about the treatment of lichen sclerosus

Kh.M., Nazran

I am so glad that I found you, you are such a kind, good, bright person. I tell everyone about you. And they also ask me what I found there in this Pyatigorsk. I answer, “I found myself a doctor.” Thank you very much for everything, happiness, health and all the best.

V.E., Kislovodsk

Thank you for the treatment you provided me. I wish you success and prosperity! It is very rare to find such professionalism. Your staff is very pleasant, the atmosphere fills with good emotions. Thank you for your health!!!

All reviews about the treatment of lichen

Psychological help

Lichen sclerosus (kraurosis) of the vulva can become a factor in emotional and psychological distress. Representatives of the fair sex, and especially young girls, do not want to go to the reception for various reasons. The itching begins and the women don’t know what to think—either her husband brought it, or she picked it up herself.

Meanwhile, the symptoms intensify, unpleasant ulcers form, and it becomes impossible to have sex. Problems begin in the family and personal life. The constant itching and burning is simply driving me crazy. Women's health problems develop into nervous and mental ones.

To avoid bringing yourself to this state, contact the Kuntsevo Medical Center for help. Friendly service staff and the absence of queues will not leave you indifferent.

The doctor will listen to you carefully and help solve your problem. The specialist will work with you on the troubles that have accumulated during this time. You will start a new life! Kraurosis is a curable disease. The sooner you start getting healthier, the better.

Leading specialists in the treatment of lichen sclerosus of the Southern Federal District

Ermolaeva Elvira Kadirovna is a well-known and recognized specialist in the North Caucasus in the field of diagnosis and treatment of kraurosis, leukoplakia, lichen sclerosus, Keir's erythroplasia and other diseases of the vulva. A good gynecologist, physiotherapist-resortologist, ultrasound doctor. Desperate and exhausted women turn to her.

Ermolaev Oleg Yurievich Candidate of Medical Sciences, gynecologist-endocrinologist with 25 years of experience and successful experience in treating lichen. Able to see relationships that elude others.

About the doctors of the Clinic in detail...

The resort clinic for women's health operates both for paid services and in the voluntary health insurance system.

Each doctor at the Clinic has long-term experience, several specializations and is able to comprehensively assess the situation.

The resort women's health clinic is open 7 days a week and on holidays:

Monday - Friday from 8.00 to 20.00, Saturday, Sunday, holidays from 8.00 to 17.00.

Treatment by appointment no later than 3 days in advance by multi-channel phone number 8 (800) 500-52-74 (calls within Russia are free), or +7 (for international calls).

Booking

The doctors of the Women's Health Resort Clinic have gained a LOT of successful EXPERIENCE in treating lichen with natural medicines and resort factors.

We accept women from all cities of Russia, near and far abroad.

The spa clinic for women's health facilitates the accommodation and accommodation of women, women with children and couples during examination and treatment.

ACCOMMODATION in Pyatigorsk is NOT INCLUDED IN THE PRICE of the course of treatment for lichen and is paid separately.

About living conditions and transfer from Mineralnye Vody airport and Pyatigorsk railway station in detail in the article “Accommodation”.

If you need to book accommodation, please coordinate your arrival date no later than 7 days in advance.

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Our Lichen Treatment Clinic is open 7 days a week and on holidays:

Monday - Friday from 8.00 to 20.00, Saturday, Sunday, holidays from 8.00 to 17.00.

Treatment by appointment via multi-channel telephone number 8 (calls within Russia are free), or (for foreign calls).

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Subsections

• Program No. 1. Treatment of inflammatory and infectious diseases of the pelvis
• Program No. 2. Treatment of urinary incontinence, prolapse and prolapse of the uterus and vagina
• Program No. 3. Treatment of female infertility
• Program No. 4. Treatment of erosion, endometriosis, leukoplakia, dysplasia, polyps, cervical cysts (uterine cysts)
• Program No. 5. Treatment of uterine fibroids
• Program No. 6. Treatment of cervicitis and endocervicitis
• Program No. 7. Postpartum rehabilitation and wumbling
• Program No. 8. Treatment of chronic cystitis
• Program No. 9. Treatment of severe menopause
• Program No. 10. Treatment of mastopathy
• Program No. 11. Treatment of endometriosis
• Program No. 12. Treatment of hydrosalpinx
• Program No. 14. Comprehensive treatment of polycystic ovary syndrome
• Program No. 15. Preconception preparation for IVF, ICSI
• Program No. 16. How to remove belly fat
• Program No. 17. Treatment of kraurosis
• Program No. 18. Treatment of leukoplakia

Treatment method

The course of complex therapy includes: injections of benzylpenicillin at a dose of 500,000 units 4 times a day intramuscularly (i.m.) for 10 days (course dose 20 million units); pentoxifylline in a dose of 100 mg, 1 tablet 3 times a day for 1 month; bovhyaluronidase azoximer in the form of vaginal (for women) or rectal (for men) suppositories at a dosage of 3000 IU once every 2 days up to a course dose of 30 thousand IU; estriol (vaginal cream) - 1 application (corresponding to 0.5 mg estriol) 1 r./day for 4 weeks, then 1 application 2 r./week. within 2 months; gel with bacteriophages Fagogin 5–7 ml 3 times a day for 1 month.

All patients with scleroatrophic lesions of the anogenital zone were treated with a fractional CO2 laser (irradiation time 220 μs, fluence 3.9 J/m2, distance between points 70 μm). Three passes were performed in each session, with the laser set to low (10 W) 20 mJ/pixel, 2 Hz in the first, second and third sessions and medium (30 W) 10 mJ/pixel, 2 Hz in the fourth and fifth sessions. Application anesthesia (lidocaine + prilocaine). The exposure time was 25 minutes. The course of treatment ranged from 3 to 5 sessions with an interval of 30 days.

As an external treatment for scleroatrophic lesions of the anogenital zone in men, we used bovhyaluronidase azoximer using phonophoresis. The course of treatment consisted of 10–12 procedures with a frequency of 1–2 r./week.