Lichen Planus vs Lichen Sclerosus: Lichen Planus And Lichen Sclerosus are two skin disorders that induce itching, although they affect different locations. Lichen planus can appear on many areas of the body, including the skin, scalp, nails, and mucous membranes such as the interior of the mouth and genitals. Lichen planus rash is often violaceous in colour and may be accompanied by small white pimples. In contrast, lichen sclerosus typically affects the genitals and adjacent regions, especially in women following menopause. The rash associated with lichen sclerosus is generally white and wrinkled, and the skin itself may shrink and become fragile.
Difference between Lichen Planus And Lichen Sclerosus
Lichen planus and lichen sclerosus are both chronic inflammatory skin conditions, but they have distinct differences in their presentation, symptoms, affected areas, and potential complications. Listed below are the differences between the two conditions:
|
Feature |
Lichen Planus |
Lichen Sclerosus |
|
Etiology |
Unknown; possibly autoimmune |
Unknown; hormonal imbalances, genetics, autoimmune processes |
|
Prevalence |
More common; affects both sexes equally |
Less common; predominantly affects women, especially postmenopausal |
|
Age of Onset |
Typically 30-60 years old |
Can occur at any age, more common in postmenopausal women |
|
Affected Areas |
Skin, oral mucosa, genitalia, scalp, nails |
Genital and anal areas, can involve extragenital skin |
|
Lesion Characteristics |
Purple, flat-topped, itchy, may have Wickham's striae |
White, shiny, smooth, fragile, may lead to scarring and atrophy |
|
Symptoms |
Itching (pruritus) common |
Itching, pain, discomfort common, particularly in genital area |
|
Complications |
Hyperpigmentation, scarring, nail deformities |
Scarring of genitalia, introital stenosis, increased risk of vulvar cancer |
|
Histopathology |
Band-like lymphocytic infiltrate, saw-toothed rete ridges |
Thin epidermis, dermal hyalinization, lymphocytic infiltrate |
|
Association with Other Conditions |
Associated with autoimmune conditions like hepatitis C, lichen planus pigmentosus |
Associated with autoimmune conditions such as thyroid disease, vitiligo |
|
Treatment |
Topical corticosteroids, oral antihistamines, immunosuppressive meds in severe cases |
Topical corticosteroids, emollients, calcineurin inhibitors, regular monitoring |
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What is Lichen Planus?
Lichen planus is an inflammatory skin condition that causes itchy, purple bumps and can affect the skin, scalp, nails, and even the inside of your mouth. It's not entirely clear what causes it, but it's not contagious.
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Key Features of Lichen Planus:
- The most distinguishing feature of lichen planus is the presence of tiny, flat-topped violaceous (purple-red) papules that may seem waxy. These papules frequently exhibit a distinctive white network of lines on their surface known as Wickham's striae.
- The Koebner phenomenon is peculiar to lichen planus. This implies that new lesions may form in scraped or irritated regions of the skin.
- Lichen planus papules can be extremely irritating and sometimes burning, making for a highly painful condition.
- Lichen planus can affect any region of the body, although the most frequent areas are the wrists, forearms, ankles, lower back, and genitals (particularly in women). It can also harm the scalp, nails, and mucous membranes of the mouth.
What is Lichen Sclerosus?
Lichen sclerosus is another inflammatory condition that thins the skin, usually around the genitals and anus. It mainly affects postmenopausal women and causes itching, white patches, and sometimes scarring. The cause is unknown as well.
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Key Features of Lichen Sclerosus:
- The afflicted skin thins and wrinkles, which is a defining feature of lichen sclerosus. The skin may also get white and glossy.
- Over time, the damaged skin may become scarred and lose flexibility. This can cause women's vaginal openings to constrict (vaginal stenosis) and make sexual intercourse difficult.
- Like lichen planus, lichen sclerosus can produce severe itching and burning in the afflicted region.
- Lichen sclerosus is most typically diagnosed in postmenopausal women, however it can afflict persons of any age or gender.
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Similarities Between Lichen Planus And Lichen Sclerosus
Lichen planus and lichen sclerosus are similar in that they are both chronically inflammatory, have the potential for scarring, and may require long-term care to control symptoms and avoid consequences. Furthermore, both illnesses can impact the vaginal region, causing pain and consequences if left untreated. Both illnesses may have autoimmune components, while the specific aetiology remains unknown.
Lichen planus and lichen sclerosus, while sometimes mistaken, are different inflammatory skin disorders. Lichen planus can affect any skin surface, including the scalp, limbs, and mucous membranes such as the mouth and genital area. It frequently manifests as violaceous, itchy pimples with the distinctive "Wickham's striae" pattern. Lichen sclerosus, on the other hand, primarily affects the anogenital area, creating white, wrinkled patches that may scar. While both disorders can cause itching and pain, lichen sclerosus seldom affects the interior of the body, whereas lichen planus can. Consultation with a dermatologist for a good diagnosis is critical for acquiring suitable treatment recommendations for lichen planus versus lichen sclerosus.
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