Lichen Sclerosus et Atrophicus (Lichen Sclerosus)

A chronic inflammatory mucocutaneous disease usually affecting the female genitalia (VULVAR LICHEN SCLEROSUS) and BALANITIS XEROTICA OBLITERANS in males. It is also called white spot disease and Csillag's disease.

Also Known As:

Networked: 373 relevant articles (40 outcomes, 42 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Localized Scleroderma (Morphea)
2.	Skin Diseases
3.	Prurigo
4.	Psoriasis (Pustulosis Palmaris et Plantaris)
5.	Granuloma Annulare

Experts

1.	Gambichler, Thilo: 7 articles (07/2013 - 02/2002)
2.	Kreuter, Alexander: 7 articles (07/2013 - 02/2002)
3.	Altmeyer, P: 6 articles (02/2012 - 01/2001)
4.	Kreuter, A: 6 articles (02/2012 - 01/2001)
5.	Wojnarowska, Fenella: 6 articles (01/2011 - 07/2003)
6.	Wojnarowska, F: 6 articles (11/2006 - 01/2000)
7.	Gonzalez, Chris M: 5 articles (07/2015 - 09/2008)
8.	Altmeyer, Peter: 5 articles (03/2013 - 02/2002)
9.	Dean, D: 5 articles (11/2006 - 01/2000)
10.	Farrell, A M: 5 articles (11/2006 - 01/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Lichen Sclerosus et Atrophicus:

1.	Tacrolimus (Prograf)FDA LinkGeneric 01/01/2008 - "Significant improvement in extensive lichen sclerosus with tacrolimus ointment and PUVA." 08/01/2013 - "Low-concentration topical tacrolimus appears to be an effective and safe treatment for children with anogenital lichen sclerosus. " 02/01/2012 - "Topical tacrolimus ointment was a safe and effective treatment for genital lichen sclerosus and should be used for long-term duration to prevent relapse. " 11/01/2006 - "Topical tacrolimus ointment 0.1% was safe and effective for the treatment of long-standing active lichen sclerosus." 11/01/2006 - "Multicentre, phase II trial on the safety and efficacy of topical tacrolimus ointment for the treatment of lichen sclerosus."
2.	Clobetasol (Clobetasol Propionate)FDA LinkGeneric 09/01/1998 - "Clobetasol propionate cream is recommended for treatment of lichen sclerosus, with a 77% chance of complete remission of symptoms and a 47% chance of improvement in the clinical appearance of the vulva. " 03/01/1999 - "Treatment with clobetasol propionate 0.05% cream is effective against lichen sclerosus et atrophicus (LSA) of the vulva. " 09/01/1998 - "To assess the efficacy of treating lichen sclerosus with clobetasol propionate. " 07/01/2014 - "At the end of the study, 28 participants (19 tacrolimus and 9 clobetasol) still had some clinical signs of lichen sclerosus (χ(2) = 6.56, P = .015). " 03/01/1999 - "Penile lichen sclerosus et atrophicus treated with clobetasol dipropionate 0.05% cream: a retrospective clinical and histopathological study."
3.	pimecrolimus (Elidel)FDA Link 10/14/2004 - "Topical pimecrolimus appears to be an effective and safe treatment for children with anogenital lichen sclerosus. " 10/01/2004 - "As lichen sclerosus is a T-lymphocyte-mediated disorder, it has been suggested that a topical macrolide immunosuppressant, such as pimecrolimus, may be a safe and effective alternative treatment for lichen sclerosus. " 02/01/2004 - "As lichen sclerosus is a T-lymphocyte mediated disorder, it has been suggested that pimecrolimus, a topical T-lymphocyte inhibitor, may be safe and effective for the treatment of lichen sclerosus in children. " 10/14/2004 - "We report on the efficacy of twice-daily application of pimecrolimus 1% cream in four prepubertal girls (range of age: 4 to 9 years) who suffered from anogenital lichen sclerosus. " 10/14/2004 - "Vehicle-controlled studies on a larger number of patients are now warranted to substantiate our promising findings, and to investigate long-term efficacy and safety of topical pimecrolimus in anogenital lichen sclerosus."
4.	Testosterone (Sustanon)FDA Link 02/01/1997 - "Topical testosterone is effective in normoandrogenic women with lichen sclerosus. " 07/01/1999 - "Reduction of lichen sclerosus has been seen with topical testosterone, and spontaneous resolution has been attributed to increasing androgen levels. " 11/01/1993 - "Testosterone pellet implant therapy for lichen sclerosus." 11/01/1989 - "Twenty-three patients diagnosed as lichen sclerosus with colposcopic directed biopsy were given topical testosterone as a first line therapy. " 11/01/1989 - "Topical testosterone for lichen sclerosus."
5.	Adrenal Cortex Hormones (Corticosteroids)IBA 01/01/2010 - "The first-line treatment is topical-potent or ultra-potent corticosteroids in the treatment of lichen sclerosis. " 06/02/2007 - "Potent local corticosteroids form the mainstay of treatment for lichen sclerosus. " 01/01/2007 - "Lichen sclerosus is a chronic relapsing disease, usually treated with ultra-potent corticosteroids. " 02/01/2004 - "As the recurrence rate of active lichen sclerosus in prepubertal girls treated with topical corticosteroids is high, and the majority of prepubertal girls with lichen sclerosus continue to have disease after menarche, a treatment regimen that does not rely on corticosteroids may be beneficial." 09/01/2002 - "Topical corticosteroids have become the treatment of choice for genital lichen sclerosus (LS) and are believed to be required for long-term relief of symptoms. "
6.	EtretinateFDA Link 08/01/1988 - "A case of lichen sclerosus et atrophicus of the vulva effectively treated with oral etretinate." 01/01/1986 - "In an open uncontrolled study eight patients with vulval lichen sclerosus et atrophicus were given etretinate (Tigason) 1 mg/kg/day. " 01/01/1989 - "For these reasons, etretinate was tried in a patient with extensive lichen sclerosus et atrophicus (LSA). " 01/01/1989 - "Etretinate reduces connective tissue degeneration in lichen sclerosus et atrophicus." 01/01/1988 - "Forty-six patients with Lichen sclerosus (Ls) of the vulva were treated with peroral etretinate for 3 months. "
7.	mometasone furoate (mometasone)FDA LinkGeneric 07/01/2015 - "Efficacy and Tolerability of Mometasone Furoate in Lichen Sclerosus: Further Confirming Evidence." 05/15/2012 - "Review: limited evidence suggests that clobetasol or mometasone is effective in genital lichen sclerosus." 01/01/2011 - " compared to placebo in one trial, clobetasol propionate 0.05% was effective in treating genital lichen sclerosus in relation to the following outcomes: 'participant-rated improvement or remission of symptoms' (risk ratio (RR) 2.85, 95% confidence interval (CI) 1.45 to 5.61) and 'investigator-rated global degree of improvement' (standardised mean difference (SMD) 5.74, 95% CI 4.26 to 7.23).When mometasone furoate 0.05% was compared to placebo in another trial, there was a significant improvement in the 'investigator-rated change in clinical grade of phimosis' (SMD -1.04, 95% CI -1.77 to -0.31).Both trials found no significant differences in reported adverse drug reactions between the corticosteroid and placebo groups. " 01/01/2011 - "The current limited evidence demonstrates the efficacy of clobetasol propionate, mometasone furoate, and pimecrolimus in treating genital lichen sclerosus. "
8.	RetinoidsIBA 02/01/1994 - "Promising results have been reported from treatment with oral retinoids in patients with severe lichen sclerosus et atrophicus (LSA) of the vulva. " 07/01/2008 - "Extragenital lichen sclerosus and atrophicus treated with topical steroids and retinoids in a child with vitiligo." 09/01/2006 - "We previously showed that (1) CD44 regulate keratinocyte proliferation; (2) topical retinoids dramatically increase the expression of CD44, hyaluronate and hyaluronate synthase (HAS)s in mouse epidermis; (3) topical retinaldehyde restores the epidermal thickness and CD44 expression which are correlated with clinical improvement in lichen sclerosus et atrophicus lesions; and (4) retinaldehyde-induced proliferative response of keratinocytes is a CD44-dependent phenomenon and requires the presence of HB-EGF, erbB1 and matrix metalloproteinases. "
9.	Retinaldehyde (Retinal)IBA 03/01/2005 - "Restored epidermal CD44 expression in lichen sclerosus et atrophicus and clinical improvement with topical application of retinaldehyde." 09/01/2006 - "We previously showed that (1) CD44 regulate keratinocyte proliferation; (2) topical retinoids dramatically increase the expression of CD44, hyaluronate and hyaluronate synthase (HAS)s in mouse epidermis; (3) topical retinaldehyde restores the epidermal thickness and CD44 expression which are correlated with clinical improvement in lichen sclerosus et atrophicus lesions; and (4) retinaldehyde-induced proliferative response of keratinocytes is a CD44-dependent phenomenon and requires the presence of HB-EGF, erbB1 and matrix metalloproteinases. "
10.	methylprednisolone aceponateIBA 10/01/2013 - "To assess the efficacy of methylprednisolone aceponate 0.1% (MPA 0.1%) in female genital lichen sclerosus (GLS) and efficacy of MPA, tacrolimus or emollient for prevention of flares. " 12/01/2013 - "To assess the efficacy of clobetasol propionate 0.05% cream in male patients suffering from genital lichen sclerosus (GLS), as well as the efficacy of methylprednisolone aceponate 0.1% cream and tacrolimus 0.1% ointment as maintenance therapy. " 12/01/2013 - "Treatment of male genital lichen sclerosus with clobetasol propionate and maintenance with either methylprednisolone aceponate or tacrolimus: a retrospective study."

Therapies and Procedures

1.	Phototherapy (Light Therapy) 02/01/2002 - "Low-dose ultraviolet A1 phototherapy for extragenital lichen sclerosus: results of a preliminary study." 09/01/2007 - "Narrowband UV-B phototherapy for extragenital lichen sclerosus." 01/01/2007 - "Progressive extragenital lichen sclerosus successfully treated with narrowband UV-B phototherapy." 05/01/2006 - "UVA1 phototherapy for genital lichen sclerosus." 10/01/2001 - "[Ultraviolet-A1 (UVA1) phototherapy in lichen sclerosus et atrophicus]."
2.	Gas Lasers 01/01/2006 - "Long-term follow-up of carbon dioxide laser treatment of lichen sclerosus shows that the treatment is safe and gives good results." 01/01/2006 - "Is carbon dioxide laser treatment of lichen sclerosus effective in the long run?" 03/01/1997 - "We have treated 10 patients (five women and five men) with lichen sclerosus (LS), verified by histopathological studies from skin biopsies, with CO2 laser vaporization. " 05/01/2010 - "Genital lichen sclerosus treated by carbon dioxide laser." 01/01/2006 - "To evaluate the long-term results after carbon dioxide laser treatment of lichen sclerosus. "
3.	Photochemotherapy (Photodynamic Therapy) 07/01/1997 - "A 66-year-old woman with longstanding lichen sclerosus et atrophicus improved strikingly with PUVA bath photochemotherapy over a period of 6 weeks. " 01/01/2015 - "Photodynamic therapy has been described as an effective therapeutic option in selected cases of anogenital lichen sclerosus that are refractory to first-line treatments. " 01/01/2009 - "Effectiveness of photodynamic therapy in the treatment of lichen sclerosus: cell changes in immunohistochemistry." 07/01/1997 - "Although long-term results are not yet available, PUVA bath photochemotherapy seems to be a promising and effective new treatment modality without systemic side effects for patients with disseminated lichen sclerosus et atrophicus." 05/01/2009 - "Comparative treatment of extragenital lichen sclerosus with methylaminolevulinic Acid pulsed dye laser-mediated photodynamic therapy or pulsed dye laser alone."
4.	Aftercare (After-Treatment) 04/01/2010 - "Adult vulval lichen sclerosus (VLS) is usually a lifelong disease with an estimated remission rate after treatment of only 16% [Arch Dermatol 2004; 140 (6): 709]. " 01/01/1990 - "Light and electron microscopic studies were carried out on 17 cases of lichen sclerosis et atrophicus of the vulva before treatment and on 8 after treatment. " 01/01/1990 - "[Light and electron microscopic studies on lichen sclerosus et atrophicus of the vulva before and after treatment]." 01/01/1993 - "Long-term control of vulval lichen sclerosus after treatment with a potent topical steroid cream."
5.	Dye Lasers 11/01/1999 - "The mechanism whereby lichen sclerosus et atrophicus is altered by the pulsed dye laser is unknown." 11/01/1999 - "A 17-year old female patient with extragenital lichen sclerosus et atrophicus was treated with the pulsed dye laser. " 11/01/1999 - "[Extragenital lichen sclerosus et atrophicus - treatment with pulsed dye laser]." 03/01/1993 - "Lichen sclerosus et atrophicus treatment with the 585-nm flashlamp-pumped pulsed dye laser." 05/01/2009 - "Comparative treatment of extragenital lichen sclerosus with methylaminolevulinic Acid pulsed dye laser-mediated photodynamic therapy or pulsed dye laser alone."