Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about lichen sclerosis.

And you can find written notes on this topic at zero definals.com slash lichen sclerosis or in the gynecology section of the zero definals obstetrics and guine

book so let's get straight into it lichen sclerosis is a chronic inflammatory skin condition that presents

with patches of scaly porcelain white description skin it commonly affects theia, the perineum and the perianal skin in

women. It can affect other areas such as the axilla or the armpit and around the thighs. It can

also affect men typically on the foreskin and the glands of the penis.

Lycansclerosis is thought to be an autoimmune condition and it's associated with other autoimmune diseases

such as type 1 diabetes, alopecia, hypothyroidism and vitiligo.

The diagnosis of lichen sclerosis is usually made clinically based on the history and examination findings.

Where there's doubt about the diagnosis, a vulval biopsy can be used to confirm it.

Let's talk in general about lichen.

Lichen sclerosis may be confused with other conditions that include lichen in the name.

Lichen refers to a flat eruption that spreads.

It's important not to get lichenschlorosis confused with lichen sylplex or lichen planus.

Lichen sympplex is chronic inflammation and irritation

caused by repeated scratching and rubbing of an area of skin.

This presents with excoriations, plaques, scaling and thickened skin.

Lycan planus is also an autoimmune condition, and it causes localised areas of chronic

inflammation, which appear as shiny, purplish, flat-topped, raised areas, and these areas have

white lines across the surface of them, which are called Wickham's striae.

So how does lichenschlorosis present? The typical presentation in your exams is a woman aged 45 to 60 years

complaining of vulval itching and skin changes in the vulval area. The condition may be asymptomatic or it could

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