lichen planus vs lichen sclerosus

2 min read 18-03-2025

Lichen planus and lichen sclerosus are chronic inflammatory skin conditions. While both can cause itchy skin lesions, they differ significantly in their appearance, location, and potential complications. Understanding these differences is crucial for proper diagnosis and treatment. This article will explore the key distinctions between lichen planus and lichen sclerosus.

What is Lichen Planus?

Lichen planus is an inflammatory skin condition affecting the skin and mucous membranes. It's characterized by itchy, flat-topped, purplish papules (small, raised bumps). These lesions often have a distinctive lacy or reticular pattern. Lichen planus can occur on various body parts, including:

Skin: Wrists, ankles, genitals, and mucous membranes of the mouth.
Mucous membranes: Inside the mouth (oral lichen planus), genitals, and esophagus.

Oral lichen planus is a common form, presenting as white patches or erosions in the mouth. This can be painful and increase the risk of oral cancer.

Symptoms of Lichen Planus

Itchy, flat-topped, purplish papules: These are the hallmark sign.
Wickham's striae: Fine, white lines on the surface of the lesions.
Burning sensation: Particularly in oral lichen planus.
Nail changes: Nail pitting, ridging, or discoloration.
Hair loss: In some cases.

Causes and Treatment of Lichen Planus

The exact cause of lichen planus isn't fully understood. It’s believed to be linked to an autoimmune response, potentially triggered by medications, infections, or other factors. Treatment focuses on managing symptoms and may include:

Corticosteroids: Topical creams or injections to reduce inflammation.
Immunosuppressants: In severe cases.
Phototherapy: Light therapy.
Other medications: To alleviate itching and discomfort.

What is Lichen Sclerosus?

Lichen sclerosus is a chronic inflammatory skin condition primarily affecting the genitals and perianal area. It’s characterized by white, thinned, wrinkled skin. This condition may appear as parchment-like skin, and often leads to significant discomfort and potential complications.

Symptoms of Lichen Sclerosus

Thin, white, wrinkled skin: A hallmark feature, especially in the genital and perianal areas.
Itching: A common and often intense symptom.
Pain: Especially during urination or sexual intercourse.
Bleeding: Following minor trauma to the affected area.
Fissures: Cracks or splits in the skin.
Vulvar or penile stenosis: Narrowing of the vaginal or urethral opening.

Causes and Treatment of Lichen Sclerosus

The exact cause of lichen sclerosus remains unknown. It's suspected to involve an autoimmune reaction. Treatment aims to control symptoms, reduce inflammation, and prevent complications. This may involve:

High-potency corticosteroids: Topical creams are the mainstay of treatment.
Tacrolimus or pimecrolimus: Topical immunomodulators.
Estrogen cream: May be helpful for postmenopausal women.
Regular monitoring: To detect and manage potential complications like cancer.