Lichen Planus vs Lichen Sclerosus: Know the Differences

Lichen Planus And Lichen Sclerosus

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.

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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.

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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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FAQ's

What is Lichen Planus?

Lichen planus is a chronic inflammatory condition that affects the skin, mucous membranes, hair, and nails. It typically appears as flat-topped, shiny, reddish-purple bumps on the skin.

What is Lichen Sclerosus?

Lichen sclerosus is a chronic inflammatory skin disorder that most commonly affects the genital and anal areas. It presents as white, patchy skin that is thinner than usual and may cause itching, discomfort, and pain.

How are Lichen Planus and Lichen Sclerosus Similar?

Both conditions are chronic inflammatory disorders of the skin. They can cause discomfort, itching, and changes in the appearance and texture of the affected skin.

How are Lichen Planus and Lichen Sclerosus Different?

While both conditions involve inflammation of the skin, lichen planus typically presents as reddish-purple bumps with a flat top, while lichen sclerosus presents as white, patchy skin that is thinner than normal. Additionally, lichen sclerosus primarily affects the genital and anal areas, whereas lichen planus can affect various parts of the body, including the skin, mouth, genitals, and nails.

Are Lichen Planus and Lichen Sclerosus Contagious?

No, neither lichen planus or lichen sclerosus are contagious. They are chronic inflammatory conditions thought to be caused by an abnormal immune response.