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Lichen sclerosus

Symptomatik, Diagnostik, therapeutisches Procedere

Lichen sclerosus

Symptoms, diagnosis, therapeutic procedures

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Zusammenfassung

Der Lichen sclerosus ist eine chronische, entzündliche Hauterkrankung, die meist den Genitalbereich betrifft. Die frühe Diagnose und anschließende, dauerhafte antientzündliche Behandlung können die Krankheit so beeinflussen, dass Patienten weitgehend symptomfrei sind und das Risiko von mutierenden Krankheitsverläufen und der Karzinomentwicklung reduziert ist.

Abstract

Lichen sclerosus is a chronic, inflammatory dermatosis that usually affects the anogenital area. Early diagnosis and subsequent long-term anti-inflammatory treatment may reduce symptoms and signs and the risk of a mutilating course and the development of carcinomas.

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Literatur

  1. Cooper SM, Gao XH, Powell JJ, Wojnarowska F (2004) Does treatment of vulvar lichen sclerosus influence its prognosis? Arch Dermatol 140:702–706

    Article  CAS  PubMed  Google Scholar 

  2. Casey GA, Cooper SM, Powell JJ (2015) Treatment of vulvar lichen sclerosus with topical corticosteroids in children: a study of 72 children. Clin Exp Dermatol 40:289–292

    Article  CAS  PubMed  Google Scholar 

  3. Lee A, Bradford J, Fischer G (2015) Long-term management of adult vulval lichen sclerosus. A prospective cohort study of 507 women. JAMA Dermatol 151:1061–1067

    Article  PubMed  Google Scholar 

  4. Kirtschig G, Becker K, Günthert A et al (2015) Evidence-based (S3) guideline on (anogenital) lichen sclerosus. J Eur Acad Dermatol Venereol 29:e1–e43

    Article  CAS  PubMed  Google Scholar 

  5. Tong LX, Sun GS, Teng JM (2015) Pediatric lichen sclerosus: a review of the epidemiology and treatment options. Pediatr Dermatol 32:593–599

    Article  PubMed  Google Scholar 

  6. Wallace HJ (1971) Lichen sclerosus et atrophicus. Trans St Johns Hosp Dermatol Soc 57:9–30

    CAS  PubMed  Google Scholar 

  7. Tasker GL, Wojnarowska F (2003) Lichen sclerosus. Clin Exp Dermatol 28:128–133

    Article  CAS  PubMed  Google Scholar 

  8. Günthert AR, Faber M, Knappe G, Hellriegel S, Emons G (2008) Early onset vulvar lichen sclerosus in premenopausal women and oral contraceptives. Eur J Obstet Gynecol Reprod Biol 137:56–60

    Article  PubMed  Google Scholar 

  9. Powell J, Wojnarowska F (2002) Childhood vulvar lichen sclerosus. The course after puberty. J Reprod Med 47:706–709

    PubMed  Google Scholar 

  10. Kizer WS, Prarie T, Morey AF (2003) Balanitis xerotica obliterans: epidemiologic distribution in an equal access health care system. South Med J 96:9–11

    Article  PubMed  Google Scholar 

  11. Edmonds EV, Hunt S, Hawkins D et al (2012) Clinical parameters in male genital lichen sclerosus: a case series of 329 patients. J Eur Acad Dermatol Venereol 26:730–737

    Article  CAS  PubMed  Google Scholar 

  12. Terlou A, Santegoets LA, van der Meijden WI et al (2012) An autoimmune phenotype in vulvar lichen sclerosus and lichen planus: a Th1 response and high levels of microRNA-155. J Invest Dermatol 132:658–666

    Article  CAS  PubMed  Google Scholar 

  13. Feig JL, Gribetz ME, Lebwohl MG (2016) Chronic lichen sclerosus successfully treated with intralesional adalimumab. Br J Dermatol 174:687–689

    Article  CAS  PubMed  Google Scholar 

  14. Lowenstein EB, Zeichner JA (2013) Intralesional adalimumab for the treatment of refractory balanitis xerotica obliterans. JAMA Dermatol 149:23–24

    Article  PubMed  Google Scholar 

  15. Sherman V, McPherson T, Baldo M et al (2010) The high rate of familial lichen sclerosus suggests a genetic contribution: an observational cohort study. J Eur Acad Dermatol Venereol 24:1031–1034

    CAS  PubMed  Google Scholar 

  16. Kirtschig G, Kuik DJ (2014) A Dutch cohort study confirms familial occurrence of anogenital lichen sclerosus. J Womens Health Care 3:6

    Google Scholar 

  17. Marren P, Yell J, Charnock FM et al (1995) The association between lichen sclerosus and antigens of the HLA system. Br J Dermatol 132:197–203

    Article  CAS  PubMed  Google Scholar 

  18. Powell J, Wojnarowska F, Winsey S, Marren P, Welsh K (2000) Lichen sclerosus premenarche: autoimmunity and immunogenetics. Br J Dermatol 142:481–484

    Article  CAS  PubMed  Google Scholar 

  19. Cooper SM, Ali I, Baldo M, Wojnarowska F (2008) The association of lichen sclerosus and erosive lichen planus of the vulva with autoimmune disease: a case-control study. Arch Dermatol 144:1432–1435

    PubMed  Google Scholar 

  20. Becker K, Meissner V, Farwick W, Bauer R, Gaiser MR (2013) Lichen sclerosus and atopy in boys: coincidence or correlation? Br J Dermatol 168:362–366

    Article  CAS  PubMed  Google Scholar 

  21. Powell JJ, Wojnarowska F (1999) Lichen sclerosus. Lancet 353:1777–1783

    Article  CAS  PubMed  Google Scholar 

  22. Bunker CB, Patel N, Shim TN (2013) Urinary voiding symptomatology (micro-incontinence) in male genital lichen sclerosus. Acta Derm Venereol 93:216–256

    Article  Google Scholar 

  23. Kirtschig G (2016) Lichen sclerosus-presentation, diagnosis and management. Dtsch Arztebl Int 113:337–343

    PubMed  PubMed Central  Google Scholar 

  24. Becker K (2011) Lichen sclerosus in boys. Dtsch Ärztebl Int 108:53–58

    PubMed  PubMed Central  Google Scholar 

  25. Kostner S, EBM Service (2014) Phimose mit Talgretetionszyste. Z Allg Med 90:339–341

    Google Scholar 

  26. Rajagopalan R, Anderson RT, Sherertz EF et al (1999) Quality of life evaluation in chronic lichen sclerosus for improved medical care. Drug Inf J 33:577–584

    Article  Google Scholar 

  27. Lansdorp CA, van den Hondel KE, Korfage IJ et al (2013) Quality of life in Dutch women with lichen sclerosus. Br J Dermatol 168:787–793

    Article  CAS  PubMed  Google Scholar 

  28. Burrows LJ, Creasey A, Goldstein AT (2011) The treatment of vulvar lichen sclerosus and female sexual dysfunction. J Sex Med 8:219–222

    Article  PubMed  Google Scholar 

  29. Dalziel KL (1995) Effect of lichen sclerosus on sexual function and parturition. J Reprod Med 40:351–354

    CAS  PubMed  Google Scholar 

  30. Marin MG, King R, Dennerstein GJ et al (1998) Dyspareunia and vulvar disease. J Reprod Med 43:952–958

    CAS  PubMed  Google Scholar 

  31. Schempp C, Bocklage H, Lange R, Kölmel HW, Orfanos CE, Gollnick H (1993) Further evidence for Borrelia burgdorferi infection in morphea and lichen sclerosus et atrophicus confirmed by DNA amplification. J Invest Dermatol 100:717–720

    Article  CAS  PubMed  Google Scholar 

  32. Edmonds E, Mavin S, Francis N et al (2009) Borrelia Burgdorferi is not associated with genital lichen sclerosus. Br J Dermatol 160:459–460

    Article  CAS  PubMed  Google Scholar 

  33. Drut RM, Gómez MA, Drut R, Lojo MM (1998) Human papillomavirus is present in some cases of childhood penile lichen sclerosus: an in situ hybridization and SP-PCR study. Pediatr Dermatol 15:85–90

    Article  CAS  PubMed  Google Scholar 

  34. Hald AK, Blaakaer J (2017) The possible role of human papillomavirus infection in the development of lichen sclerosus. Int J Dermatol. https://doi.org/10.1111/ijd.13697

    PubMed  Google Scholar 

  35. Neill SM, Lewis FM, Tatnall FM, Cox NH (2010) British Association of Dermatologists. British Association of Dermatologists’ guidelines for the management of lichen sclerosus. Br J Dermatol 2010(163):672–682

    Article  Google Scholar 

  36. Lewis FM, Tatnall FM, Velangi SS et al (2018) British Association of Dermatologists guidelines for the management of lichen sclerosus 2018. Br J Dermatol. https://doi.org/10.1111/bjd.16241

    Google Scholar 

  37. Niamh L, Naveen S, Hazel B (2009) Diagnosis of vulval inflammatory dermatoses: a pathological study with clinical correlation. Int J Gynecol Pathol 28:554–558

    Article  PubMed  Google Scholar 

  38. Kirtschig G, Gynecologic Dermatology CAS (2016) Symptoms, signs and clinical management, 1. Aufl. Jp Medical Ltd, London

    Google Scholar 

  39. Virgili A, Minghetti S, Borghi A, Corazza M (2013) Long-term maintenance therapy for vulvar lichen sclerosus: the results of a randomized study comparing topical vitamin E with an emollient. Eur J Dermatol 23:189–194

    CAS  PubMed  Google Scholar 

  40. Simonart T, Lahaye M, Simonart J‑M (2008) Vulvar lichen sclerosus: effect of maintenance treatment with a moisturizer on the course of the disease. Menopause 15:74–77

    PubMed  Google Scholar 

  41. D’Antuono A, Bellavista S, Negosanti F et al (2011) Dermasilk briefs in vulvar lichen sclerosus: an adjuvant tool. J Low Genit Tract Dis 15:287–291

    Article  PubMed  Google Scholar 

  42. Goldstein AT, Thac D, Luger T (2009) Topical calcineurin inhibitors for the treatment of vulvar dermatoses. Eur J Obstet Gynecol Reprod Biol 146:22–29

    Article  CAS  PubMed  Google Scholar 

  43. Mirastschijski U, Schwenke C, Melchior S, Buried Penis CC (2017) A comprehensive review on aetiology, classification and plastic-surgical reconstruction. Handchir Mikrochir Plast Chir 49:78–84

    Article  PubMed  Google Scholar 

  44. Stein R, Beetz R, Thüroff JW (2011) Kinderurologie in Klinik und Praxis, 3. Aufl. Thieme, Stuttgart. ISBN 978-3136748039

    Google Scholar 

  45. Rödder K, Olianas R, Fisch M (2006) Urethral strictures – operative strategy. Urologe A 45:499–511

    Article  PubMed  Google Scholar 

  46. Pandey A, Dican R, Beier J, Keller H (2014) Buccal mucosal graft in reconstructive urology: uses beyond urethral stricture. Int J Urol 21:732–734

    Article  PubMed  Google Scholar 

  47. Casabona F, Gambelli I, Casabona F et al (2017) Autologous platelet-rich plasma (PRP) in chronic penile lichen sclerosus: the impact on tissue repair and patient quality of life. Int Urol Nephrol 49:573–580

    Article  PubMed  Google Scholar 

  48. Goldstein AT, King M, Runels C et al (2017) Intradermal injection of autologous platelet-rich plasma for the treatment of vulvar lichen sclerosus. J Am Acad Dermatol 76:158–160

    Article  PubMed  Google Scholar 

  49. Lee A, Lim A, Fischer G (2016) Fractional carbon dioxide laser in recalcitrant vulval lichen sclerosus. Australas J Dermatol 57:39–43

    Article  PubMed  Google Scholar 

  50. Bradford J, Fischer G (2013) Surgical division of labial adhesions in vulvar lichen sclerosus and lichen planus. J Low Genit Tract Dis 17:48–50

    Article  PubMed  Google Scholar 

  51. Halonen P, Jakobsson M, Heikinheimo O et al (2017) Lichen sclerosus and risk of cancer. Int J Cancer 140:1998–2002

    Article  CAS  PubMed  Google Scholar 

  52. http://nottingham.ac.uk/research/groups/cebd/projects/5rareandother/ls-psp/index.aspx

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Authors and Affiliations

  1. Hautklinik, Universitätsklinikum Marburg & Gießen, Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland

    G. Kirtschig

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Correspondence to G. Kirtschig.

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G. Kirtschig gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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Kirtschig, G. Lichen sclerosus. Hautarzt 69, 127–133 (2018). https://doi.org/10.1007/s00105-017-4121-2

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