Materiały źródłowe

• #1 Lichen sclerosus | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/lichen-sclerosus

  The exact cause of lichen sclerosus isn’t known. It’s likely a combination of factors, including an overactive immune system, your genetic makeup, and previous skin damage or irritation. […] Lichen sclerosus isn’t contagious and can’t be spread through sexual contact.

• #2 Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7191405/

  The etiology of LS remains unknown, but several mechanisms have been studied for this noncontagious disease. […] Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local and infectious background. […] Genetic association to LS has been shown in family and twin studies. […] There is a strong association between LS and autoimmune disease in adults. […] Infections such as with Borrelia burgdorferi, causative agent of Lyme disease, have been implicated, but the evidence is contradictory. […] A well-known manifestation of VLS is the Koebner phenomenon. […] The bimodal distribution of the disease in prepubertal and postmenopausal women suggests its association with low estrogen levels as in these women. […] Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local and infectious background.

• #3 Lichen Sclerosus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1123316-overview

  Lichen sclerosus (LS) is a chronic inflammatory dermatosis of unknown cause that most commonly affects the genitalia (vulvar and penile lichen sclerosus) but can occur at any skin site (extragenital lichen sclerosus). […] The etiology and pathogenesis of LS have not been defined but may include genetic, infectious, environmental, and hormonal factors. […] Several older studies linked borrelial or other infections with LS, but most subsequent studies have disputed this finding, with polymerase chain reaction (PCR)-based studies showing no increased incidence of borrelial infection. […] Exploration of genetic and autoimmune factors has not identified consistent, reproducible patterns, though autoantibodies to ECM protein 1 have been reported. […] A genetic predisposition, based on family clustering, has been described.

• #4 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Lichen sclerosus (LS) is a skin disorder that causes the skin to become thin, whitened, and wrinkled and can cause itching or pain. […] The cause of vulvar lichen sclerosus (LS) is not clear; health care providers suspect that a number of factors may be involved. […] Genetic factors – LS seems to be more common in some families. However, the role of genetics in LS is not fully understood. […] Disorders of the immune system – LS in females may be an autoimmune disorder, in which the body’s immune system mistakenly attacks and injures the skin. Adult females with LS are at greater risk of developing other autoimmune disorders, such as some types of thyroid disease, anemia, diabetes, alopecia areata, and vitiligo. […] Infections – Researchers have not been able to clearly demonstrate any relationship between infections and LS. LS is not contagious.

• #5 Lichen Sclerosus: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16564-lichen-sclerosus

  Lichen sclerosus is a chronic inflammatory condition that affects skin on your genitals. Healthcare providers dont understand what causes lichen sclerosus, but they think it may be an autoimmune disease. […] Healthcare providers and medical researchers arent sure what causes lichen sclerosus. However, they think there may be a link to autoimmune diseases. […] Genetics and hormonal changes may also determine who gets the disorder. […] In some cases, lichen sclerosus develops after someone experiences trauma, such as an injury or sexual abuse. […] Healthcare providers and medical researchers continue to research lichen sclerosus to pinpoint its exact causes. […] Theres not enough data available to classify lichen sclerosus as an autoimmune disease. But people with lichen sclerosus do commonly have autoimmune disorders, including: […] The close associations between these conditions and lichen sclerosus suggest that the condition may arise from autoimmune responses in your body.

• #6 Lichen sclerosus: Causes, Diagnosis, and Images – DermNet

  https://dermnetnz.org/topics/lichen-sclerosus

  Lichen sclerosus is a common chronic inflammatory skin disorder that most often affects genital and perianal areas. […] The cause of lichen sclerosus is not fully understood and may include genetic, hormonal, irritant, traumatic, and infectious components. […] Lichen sclerosus is often classified as an autoimmune disease. Autoimmune diseases are associated with antibodies to a specific protein. […] Extracellular matrix protein-1 (ECM-1) antibodies have been detected in 60-80% of women with vulval lichen sclerosus. […] Male genital lichen sclerosus is rare in men circumcised in infancy. It has been suggested that it may be caused by chronic, intermittent damage by urine occluded under the foreskin. […] As onset in women is commonly postmenopausal, a relative lack of oestrogen may be significant.

• #7 Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets

  https://www.ijbs.com/v15p1429.htm

  The association between LS and autoimmune disease has been well-established in women, but less so in men. […] Such findings further confirmed prior case-control reports by Harrington and Dunsmore and Cooper et al., citing 34% and 28.4% of LS women having comorbidity with at least one other autoimmune disease compared to healthy controls, respectively. […] This suggests there is a strong, positive association between LS and autoimmune disease in women and in contrast, a weak association in men. […] LS genetic susceptibility is also strengthened by a significant positive association with genes regulating HLA class II antigens, which are critical regulators of humoral immunity. […] Given the familial occurrence of LS and the close, positive association between HLA class II antigens and autoimmune disease, many researchers speculated LS pathogenesis may progress along an immunogenetic route towards humoral autoimmunity as the development of autoantibodies to an unknown autoantigen may account for the histological changes seen as extensive extracellular remodeling.

• #8 Lichen Sclerosus | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/l/lichen-sclerosus.html

  Lichen sclerosus is a long-term (chronic) skin condition. […] Experts are still working to understand what causes lichen sclerosus. It runs in families, so experts think that certain genes may play a role. […] Some factors that may lead to the condition are: Problems with your immune system, Hormonal imbalances, especially with estrogen, Past skin damage. […] You may have a greater risk for lichen sclerosus if you have an autoimmune disease, such as: Autoimmune-related thyroid disease, Autoimmune-related anemia, Vitiligo, Type 1 diabetes, Alopecia areata. […] Other factors that can increase your risk include: A history of sexual abuse, A history of the condition in your family. […] Circumcision greatly lowers the risk of lichen sclerosus in men. […] Vulvar lichen sclerosus may slightly increase the risk of squamous cell skin cancer in women. Men with lichen sclerosus on the penis may also have an increased risk. […] Untreated advanced lichen sclerosus may permanently change the look of your genitals.

• #9 Lichen sclerosus: Symptoms, Causes, and Treatment

  https://patient.info/womens-health/vulval-problems-leaflet/lichen-sclerosus

  Lichen sclerosus is an uncommon skin condition. […] The cause of lichen sclerosus is not known. In lichen sclerosus, inflammation of the affected skin changes the structure of the skin. […] Lichen sclerosus is probably an autoimmune disease. An autoimmune condition is one where the body’s immune system accidentally attacks your own body. This causes inflammation and damage to the affected part of the body. […] In people with lichen sclerosus the genital area of skin may be attacked by some parts of the immune system which then causes inflammation. However, this has not been proved and it is not really known what triggers lichen sclerosus to develop. […] About 1 in 4 people with lichen sclerosus have another autoimmune disease such as thyroid disease, vitiligo, or pernicious anaemia. This is why it is thought that lichen sclerosus might be an autoimmune disease.

• #10 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Lichen sclerosus is a chronic inflammatory skin disease. […] The cause of lichen sclerosus is unknown. Presumably there is a genetic predisposition. Approximately 10% of patients with lichen sclerosus have relatives with the same disease, potentially the percentage is much higher. […] Immunological changes on the level of T and B cells have been described. Thus an autoimmune phenotype has been observed in the case of vulvar lichen sclerosus involving increased levels of Th1-specific cytokines, dense T cell infiltration and enhanced BIC/miR-155 expression as well as autoantibodies against extracellular matrix protein 1 and BP180 antigen. […] Oxidative DNA damage and TP53 mutations (tumor suppressor gene) have also been described. This could indicate an autoimmune background of lichen sclerosus and play a role in the slightly increased risk of vulval carcinoma.

• #11 Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects

  https://www.mdpi.com/resolver?pii=biomedicines9080950

  To date, the etiology and pathogenesis of VLS are not well defined. The available evidence indicates the role of two main pathomechanisms, which act on a susceptible genetic background. […] It is conceivable that in VLS, as in other dermatological chronic inflammatory disorders, immune dysreactivity and pathological changes are closely associated. […] A family history of LS has been shown in several studies. […] A significant positive association with genes regulating HLA class II antigens further strengthens the view that there is a genetic susceptibility to VLS. […] Several lines of evidence suggest a pivotal role of autoimmunity in VLS pathogenesis. […] Immunological dysreactivity and autoimmune response appear relevant pathophysiological mechanisms. […] An abnormal activation of a Th1 autoimmune response has been found in affected tissue.

• #12 Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects

  https://www.mdpi.com/resolver?pii=biomedicines9080950

  This immune imbalance perpetuates an up-regulation of pro-inflammatory cytokines and, in turn, leads to a cell-mediated attack against self-antigens. […] Promoting fibroblast growth and activity, as well as abnormal collagen synthesis, is another crucial event in VLS pathogenesis and progressive formation of hyalinised and sclerotic dermal tissue. […] Several agents have been investigated as possible causal or triggering agents of LS. […] Convincing evidence is lacking but it cannot be excluded that exogenous agents can trigger immune activation and inflammation. […] The current evidence on physiopathology of VLS points towards a complex, multifactorial process. […] It is conceivable that environmental factors acting on a genetic background trigger autoimmune processes, with subsequent inflammation which, in turn, leads to tissue and microvascular injury as well as to activation of signalling pathways involved in fibroblast and collagen metabolism.

• #13 Lichen sclerosus – Wikipedia

  https://en.wikipedia.org/wiki/Lichen_sclerosus

  Lichen sclerosus (LS) is a chronic, inflammatory skin disease, of unknown cause, which can affect any body part of any person, but has a strong preference for the genitals (penis, vulva), and is also known as balanitis xerotica obliterans when it affects the penis. […] Although it is not clear what causes LS, several theories have been postulated. Lichen sclerosus is not contagious and cannot be caught from another person. […] Several risk factors have been proposed, including exposure to the irritant effects of urine, autoimmune diseases, infections and genetic predisposition. […] There is a growing body of evidence suggesting that prolonged exposure of susceptible tissues to the irritant effects of urine may contribute to the development of lichen sclerosus. […] Lichen sclerosus may have a genetic component. A high correlation of lichen sclerosus has been reported between twins and between family members.

• #14 Lichen Sclerosus | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/lichen-sclerosus/

  Although the cause of lichen sclerosus has not been determined, research suggests it results from an autoimmune reaction in people who are genetically predisposed to the condition. […] Hormonal imbalance and previous skin damage might also be contributing factors. […] Other factors that might increase risk include having a family history of the condition.

• #15 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Lichen sclerosus is a chronic inflammatory skin disease. […] The cause of lichen sclerosus is unknown. Presumably there is a genetic predisposition. Approximately 10% of patients with lichen sclerosus have relatives with the same disease, potentially the percentage is much higher. […] Immunological changes on the level of T and B cells have been described. Thus an autoimmune phenotype has been observed in the case of vulvar lichen sclerosus involving increased levels of Th1-specific cytokines, dense T cell infiltration and enhanced BIC/miR-155 expression as well as autoantibodies against extracellular matrix protein 1 and BP180 antigen. […] Oxidative DNA damage and TP53 mutations (tumor suppressor gene) have also been described. This could indicate an autoimmune background of lichen sclerosus and play a role in the slightly increased risk of vulval carcinoma.

• #16 Lichen sclerosus – Wikipedia

  https://en.wikipedia.org/wiki/Lichen_sclerosus

  Lichen sclerosus (LS) is a chronic, inflammatory skin disease, of unknown cause, which can affect any body part of any person, but has a strong preference for the genitals (penis, vulva), and is also known as balanitis xerotica obliterans when it affects the penis. […] Although it is not clear what causes LS, several theories have been postulated. Lichen sclerosus is not contagious and cannot be caught from another person. […] Several risk factors have been proposed, including exposure to the irritant effects of urine, autoimmune diseases, infections and genetic predisposition. […] There is a growing body of evidence suggesting that prolonged exposure of susceptible tissues to the irritant effects of urine may contribute to the development of lichen sclerosus. […] Lichen sclerosus may have a genetic component. A high correlation of lichen sclerosus has been reported between twins and between family members.

• #17 Frontiers | Lichen sclerosus: The 2023 update

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1106318/full

  Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. The etiology of LS is still unknown. Hormonal status, frequent trauma and autoimmune diseases are well-known associations for LS, yet infections do not seem to be clear risk factors. LS pathogenesis involves factors such as a genetic predisposition and an immune-mediated Th1-specific IFNγ-induced phenotype. […] The etiology and pathogenesis of LS are still not fully elucidated. There is a genetic and familial predisposition in LS, whereas frequent trauma, hormonal status and certain drugs could also play a role in the pathogenesis. LS is a type 1 T helper (Th1) mediated and miR-155 dependent immune-mediated disease. […] A positive family history of LS in first-degree female relatives can be found in 12% of patients. HLA-DR and DQ are supposed to be involved in the susceptibility and protection from LS.

• #18 Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets

  https://www.ijbs.com/v15p1429.htm

  The association between LS and autoimmune disease has been well-established in women, but less so in men. […] Such findings further confirmed prior case-control reports by Harrington and Dunsmore and Cooper et al., citing 34% and 28.4% of LS women having comorbidity with at least one other autoimmune disease compared to healthy controls, respectively. […] This suggests there is a strong, positive association between LS and autoimmune disease in women and in contrast, a weak association in men. […] LS genetic susceptibility is also strengthened by a significant positive association with genes regulating HLA class II antigens, which are critical regulators of humoral immunity. […] Given the familial occurrence of LS and the close, positive association between HLA class II antigens and autoimmune disease, many researchers speculated LS pathogenesis may progress along an immunogenetic route towards humoral autoimmunity as the development of autoantibodies to an unknown autoantigen may account for the histological changes seen as extensive extracellular remodeling.

• #19 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Hormones – Vulvar LS is more common in prepubertal females and postmenopausal females, suggesting that hormonal changes influence the disease. However, treatments such as hormone replacement therapy or the application of testosterone or progesterone have not been shown to be effective for females with LS. […] Skin injury – People with vulvar LS sometimes develop symptoms in places where the skin has been injured, such as from physical trauma or sexual abuse. […] Urine – There is evidence that urine may contribute to genital LS in males, in that microscopic droplets of urine may pool between the glans penis and the foreskin, contributing to LS in uncircumcised males. Further research is needed to determine whether urine contributes to more severe or difficult-to-control vulvar LS in females.

• #20 Lichen Sclerosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lichen-sclerosus

  Lichen sclerosus is a chronic inflammatory skin disease that affects five to ten times as many women (most frequently postmenopausal) as men. […] The cause of lichen sclerosus is unknown, though research has found links to genetic, environmental, hormonal, and immune-related factors. […] For instance, some evidence suggests a genetic predisposition in some people, for whom the condition may be triggered by injury or trauma to the affected area. […] Other studies suggest that some cases of lichen sclerosus reflect an autoimmune disorder, meaning that the body’s immune system attacks healthy cells which ultimately leads to the development of skin lesions and other symptoms of the condition. […] Yet other studies suggest that low levels of the hormone estrogen may be a cause of lichen sclerosus, though the relationship between estrogen and the disease is not fully understood.

• #21 Lichen sclerosus: Symptoms, Causes, and Treatment

  https://patient.info/womens-health/vulval-problems-leaflet/lichen-sclerosus

  Although we don’t know exactly what causes lichen sclerosus, several risk factors have been identified: Gender. Lichen sclerosus is more common in women than in men. […] Genetics. Lichen sclerosus seems to be more common in some families; it may be that some people inherit genes that make them more likely to develop lichen sclerosus after something else happens, such as an injury. […] Age and hormones. Lichen sclerosus most commonly develops in women after the menopause, and, less commonly, girls who have not yet gone through puberty. Hormones, such as oestrogen and progesterone, are low in pre-pubertal girls and post-menopausal women, and may be linked to the condition.

• #22 Vulvar Lichen Sclerosus: Causes, Symptoms and Treatment | Evvy

  https://www.evvy.com/blog/vulvar-lichen-sclerosus

  Lichen sclerosus can affect anyone regardless of age or sex, but people with vaginas are more likely to have it especially after going through menopause. […] The main theory is that its caused by an autoimmune disease, which is when the bodys immune system is overactive and attacks healthy cells for unknown reasons. […] Studies have shown that women with lichen sclerosus are more likely to have an autoimmune disease like: Diabetes, Alopecia areata, Anemia, Thyroid disease, Vitiligo. […] While lichen sclerosus has been linked to the formation of certain antibodies, theres still no conclusive evidence suggesting that lichen sclerosus is itself an autoimmune disorder. […] Since vulvar lichen sclerosus affects girls before puberty and postmenopausal women, some researchers believe low levels of reproductive hormones like estrogen may play a role.

• #23 Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7191405/

  The etiology of LS remains unknown, but several mechanisms have been studied for this noncontagious disease. […] Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local and infectious background. […] Genetic association to LS has been shown in family and twin studies. […] There is a strong association between LS and autoimmune disease in adults. […] Infections such as with Borrelia burgdorferi, causative agent of Lyme disease, have been implicated, but the evidence is contradictory. […] A well-known manifestation of VLS is the Koebner phenomenon. […] The bimodal distribution of the disease in prepubertal and postmenopausal women suggests its association with low estrogen levels as in these women. […] Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local and infectious background.

• #24 Lichen Sclerosus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1123316-overview

  Local irritation or trauma seems to play a role in some cases of LS, especially in genetically predisposed individuals. […] Oral contraceptives in premenopausal women have been shown to give rise to a relative risk of 2.5, which suggests an altered hormonal axis as a possible contributory factor. […] LS may occur in association with other inflammatory conditions, including psoriasis. […] A systematic review and meta-analysis of 21 case-control studies by Baglama et al found that both male and female LS patients had a higher incidence of certain dermatologic conditions (lichen planus, vitiligo, alopecia areata, atopic dermatitis, and psoriasis), certain cardiovascular risk factors (essential hypertension, obesity, dyslipidemia, and diabetes mellitus), genital warts, and hypothyroidism in comparison with control subjects.

• #25 Frontiers | Lichen sclerosus: The 2023 update

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1106318/full

  The role of the hormones in LS is controversial. In the past, hypoestrogenism was considered a risk factor of VLS, due to its typical presentation during pre-puberty and postmenopause. However, this theory could not be proved. […] There are no triggering infections associated with LS. However, there are many reports of the presence of HPV16 in the prepuce of not only adult men, but also in boys before having sexual intercourse. […] The association of LS and medications is occasional. There are reports of blistering variants of LS, gLS and eLS with imatinib mesylate in patients treated for chronic myelogenous leukemia and gastrointestinal stromal tumor.

• #26 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Hormones – Vulvar LS is more common in prepubertal females and postmenopausal females, suggesting that hormonal changes influence the disease. However, treatments such as hormone replacement therapy or the application of testosterone or progesterone have not been shown to be effective for females with LS. […] Skin injury – People with vulvar LS sometimes develop symptoms in places where the skin has been injured, such as from physical trauma or sexual abuse. […] Urine – There is evidence that urine may contribute to genital LS in males, in that microscopic droplets of urine may pool between the glans penis and the foreskin, contributing to LS in uncircumcised males. Further research is needed to determine whether urine contributes to more severe or difficult-to-control vulvar LS in females.

• #27 Lichen Sclerosus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1123316-overview

  Local irritation or trauma seems to play a role in some cases of LS, especially in genetically predisposed individuals. […] Oral contraceptives in premenopausal women have been shown to give rise to a relative risk of 2.5, which suggests an altered hormonal axis as a possible contributory factor. […] LS may occur in association with other inflammatory conditions, including psoriasis. […] A systematic review and meta-analysis of 21 case-control studies by Baglama et al found that both male and female LS patients had a higher incidence of certain dermatologic conditions (lichen planus, vitiligo, alopecia areata, atopic dermatitis, and psoriasis), certain cardiovascular risk factors (essential hypertension, obesity, dyslipidemia, and diabetes mellitus), genital warts, and hypothyroidism in comparison with control subjects.

• #28 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  It is assumed that trauma plays a significant role as trigger in the development of lichen sclerosus. Such traumas include scratching, friction (e.g., caused by tight clothing), occlusion, surgical procedures or sexual abuse during childhood. […] There is no compelling indication of an infectious trigger of lichen sclerosus. There is in particular no indication of an association of Borrelia burgdorferi or HPV (human papilloma virus) infections with lichen sclerosus. […] The higher incidence of lichen sclerosus in postmenopausal women suggests that the hormonal status may be of pathogenetic relevance.

• #29 Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7191405/

  The etiology of LS remains unknown, but several mechanisms have been studied for this noncontagious disease. […] Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local and infectious background. […] Genetic association to LS has been shown in family and twin studies. […] There is a strong association between LS and autoimmune disease in adults. […] Infections such as with Borrelia burgdorferi, causative agent of Lyme disease, have been implicated, but the evidence is contradictory. […] A well-known manifestation of VLS is the Koebner phenomenon. […] The bimodal distribution of the disease in prepubertal and postmenopausal women suggests its association with low estrogen levels as in these women. […] Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local and infectious background.

• #30 Lichen sclerosus (in males) – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/lichen-sclerosus-in-males/?q=https://knowyourskin.britishskinfoundation.org.uk/condition/

  Lichen sclerosus is a chronic inflammatory skin condition which can affects any part of the skin, but in men is most often seen on the foreskin and tip of the penis. […] What causes lichen sclerosus is not fully understood. It almost never occurs in men who have been circumcised early in life. […] Lichen sclerosus is not caused by an infection and, although the genital area is affected, cannot be passed to a sexual partner. […] Lichen sclerosus may affect some men with auto-immune diseases such as thyroid disease or diabetes, although this link is more common in women. It may also be linked to atopic conditions such as eczema, asthma and hayfever. […] Friction or damage to the skin can bring out lichen sclerosus and make it worse. This is called a Koebner response and is sometimes seen after surgery. […] There is a link in some men between lichen sclerosus and penis cancer, but it is rare. Although circumcision may reduce the risk, it does not absolutely prevent penis cancer. […] Although there are some reports of familial lichen sclerosus, it does not usually run in families.

• #31 Lichen sclerosus

  https://www.nhs.uk/conditions/lichen-sclerosus/

  The cause of lichen sclerosus is unknown. […] It might be caused by your immune system, the body’s defence against infection, mistakenly attacking and damaging your skin. […] Lichen sclerosus is: not caused by an infection […] not contagious you cannot spread it to other people through close contact, including sex […] not caused by poor personal hygiene. […] Rubbing or damage to the skin can trigger lichen sclerosus or make it worse.

• #32 Lichen sclerosus: Causes, Diagnosis, and Images – DermNet

  https://dermnetnz.org/topics/lichen-sclerosus

  Lichen sclerosus is a common chronic inflammatory skin disorder that most often affects genital and perianal areas. […] The cause of lichen sclerosus is not fully understood and may include genetic, hormonal, irritant, traumatic, and infectious components. […] Lichen sclerosus is often classified as an autoimmune disease. Autoimmune diseases are associated with antibodies to a specific protein. […] Extracellular matrix protein-1 (ECM-1) antibodies have been detected in 60-80% of women with vulval lichen sclerosus. […] Male genital lichen sclerosus is rare in men circumcised in infancy. It has been suggested that it may be caused by chronic, intermittent damage by urine occluded under the foreskin. […] As onset in women is commonly postmenopausal, a relative lack of oestrogen may be significant.

• #33 Lichen Sclerosus in Men — DermNet

  https://dermnetnz.org/topics/lichen-sclerosus-in-men

  Lichen sclerosus on the penis may be due to the long-term effect of occlusion of urine between susceptible epithelia causing irritation and inflammation on the glans and prepuce. […] Lichen sclerosus is rare in men who were circumcised at birth. […] There is no convincing evidence that it is an autoimmune disease nor that it is an infection, although its relationship to HPV in the development of penile intraepithelial neoplasia and penile cancer remains a fertile area of investigation.

• #34 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Lichen sclerosus (LS) is a skin disorder that causes the skin to become thin, whitened, and wrinkled and can cause itching or pain. […] The cause of vulvar lichen sclerosus (LS) is not clear; health care providers suspect that a number of factors may be involved. […] Genetic factors – LS seems to be more common in some families. However, the role of genetics in LS is not fully understood. […] Disorders of the immune system – LS in females may be an autoimmune disorder, in which the body’s immune system mistakenly attacks and injures the skin. Adult females with LS are at greater risk of developing other autoimmune disorders, such as some types of thyroid disease, anemia, diabetes, alopecia areata, and vitiligo. […] Infections – Researchers have not been able to clearly demonstrate any relationship between infections and LS. LS is not contagious.

• #35 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  It is assumed that trauma plays a significant role as trigger in the development of lichen sclerosus. Such traumas include scratching, friction (e.g., caused by tight clothing), occlusion, surgical procedures or sexual abuse during childhood. […] There is no compelling indication of an infectious trigger of lichen sclerosus. There is in particular no indication of an association of Borrelia burgdorferi or HPV (human papilloma virus) infections with lichen sclerosus. […] The higher incidence of lichen sclerosus in postmenopausal women suggests that the hormonal status may be of pathogenetic relevance.

• #36 Lichen Sclerosus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1123316-overview

  Lichen sclerosus (LS) is a chronic inflammatory dermatosis of unknown cause that most commonly affects the genitalia (vulvar and penile lichen sclerosus) but can occur at any skin site (extragenital lichen sclerosus). […] The etiology and pathogenesis of LS have not been defined but may include genetic, infectious, environmental, and hormonal factors. […] Several older studies linked borrelial or other infections with LS, but most subsequent studies have disputed this finding, with polymerase chain reaction (PCR)-based studies showing no increased incidence of borrelial infection. […] Exploration of genetic and autoimmune factors has not identified consistent, reproducible patterns, though autoantibodies to ECM protein 1 have been reported. […] A genetic predisposition, based on family clustering, has been described.

• #37 Frontiers | Lichen sclerosus: The 2023 update

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1106318/full

  The role of the hormones in LS is controversial. In the past, hypoestrogenism was considered a risk factor of VLS, due to its typical presentation during pre-puberty and postmenopause. However, this theory could not be proved. […] There are no triggering infections associated with LS. However, there are many reports of the presence of HPV16 in the prepuce of not only adult men, but also in boys before having sexual intercourse. […] The association of LS and medications is occasional. There are reports of blistering variants of LS, gLS and eLS with imatinib mesylate in patients treated for chronic myelogenous leukemia and gastrointestinal stromal tumor.

• #38 Lichen Sclerosus in Men — DermNet

  https://dermnetnz.org/topics/lichen-sclerosus-in-men

  Lichen sclerosus on the penis may be due to the long-term effect of occlusion of urine between susceptible epithelia causing irritation and inflammation on the glans and prepuce. […] Lichen sclerosus is rare in men who were circumcised at birth. […] There is no convincing evidence that it is an autoimmune disease nor that it is an infection, although its relationship to HPV in the development of penile intraepithelial neoplasia and penile cancer remains a fertile area of investigation.

• #39 Lichen Sclerosus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1123316-overview

  Local irritation or trauma seems to play a role in some cases of LS, especially in genetically predisposed individuals. […] Oral contraceptives in premenopausal women have been shown to give rise to a relative risk of 2.5, which suggests an altered hormonal axis as a possible contributory factor. […] LS may occur in association with other inflammatory conditions, including psoriasis. […] A systematic review and meta-analysis of 21 case-control studies by Baglama et al found that both male and female LS patients had a higher incidence of certain dermatologic conditions (lichen planus, vitiligo, alopecia areata, atopic dermatitis, and psoriasis), certain cardiovascular risk factors (essential hypertension, obesity, dyslipidemia, and diabetes mellitus), genital warts, and hypothyroidism in comparison with control subjects.

• #40 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Hormones – Vulvar LS is more common in prepubertal females and postmenopausal females, suggesting that hormonal changes influence the disease. However, treatments such as hormone replacement therapy or the application of testosterone or progesterone have not been shown to be effective for females with LS. […] Skin injury – People with vulvar LS sometimes develop symptoms in places where the skin has been injured, such as from physical trauma or sexual abuse. […] Urine – There is evidence that urine may contribute to genital LS in males, in that microscopic droplets of urine may pool between the glans penis and the foreskin, contributing to LS in uncircumcised males. Further research is needed to determine whether urine contributes to more severe or difficult-to-control vulvar LS in females.

• #41 Lichen sclerosus – Wikipedia

  https://en.wikipedia.org/wiki/Lichen_sclerosus

  Lichen sclerosus (LS) is a chronic, inflammatory skin disease, of unknown cause, which can affect any body part of any person, but has a strong preference for the genitals (penis, vulva), and is also known as balanitis xerotica obliterans when it affects the penis. […] Although it is not clear what causes LS, several theories have been postulated. Lichen sclerosus is not contagious and cannot be caught from another person. […] Several risk factors have been proposed, including exposure to the irritant effects of urine, autoimmune diseases, infections and genetic predisposition. […] There is a growing body of evidence suggesting that prolonged exposure of susceptible tissues to the irritant effects of urine may contribute to the development of lichen sclerosus. […] Lichen sclerosus may have a genetic component. A high correlation of lichen sclerosus has been reported between twins and between family members.

• #42 Lichen Sclerosus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1123316-overview

  Local irritation or trauma seems to play a role in some cases of LS, especially in genetically predisposed individuals. […] Oral contraceptives in premenopausal women have been shown to give rise to a relative risk of 2.5, which suggests an altered hormonal axis as a possible contributory factor. […] LS may occur in association with other inflammatory conditions, including psoriasis. […] A systematic review and meta-analysis of 21 case-control studies by Baglama et al found that both male and female LS patients had a higher incidence of certain dermatologic conditions (lichen planus, vitiligo, alopecia areata, atopic dermatitis, and psoriasis), certain cardiovascular risk factors (essential hypertension, obesity, dyslipidemia, and diabetes mellitus), genital warts, and hypothyroidism in comparison with control subjects.

• #43 Lichen Sclerosus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1123316-overview

  Local irritation or trauma seems to play a role in some cases of LS, especially in genetically predisposed individuals. […] Oral contraceptives in premenopausal women have been shown to give rise to a relative risk of 2.5, which suggests an altered hormonal axis as a possible contributory factor. […] LS may occur in association with other inflammatory conditions, including psoriasis. […] A systematic review and meta-analysis of 21 case-control studies by Baglama et al found that both male and female LS patients had a higher incidence of certain dermatologic conditions (lichen planus, vitiligo, alopecia areata, atopic dermatitis, and psoriasis), certain cardiovascular risk factors (essential hypertension, obesity, dyslipidemia, and diabetes mellitus), genital warts, and hypothyroidism in comparison with control subjects.

• #44 Lichen sclerosus: Symptoms, causes & treatment | Healthy Male

  https://healthymale.org.au/mens-health/lichen-sclerosus

  Lichen sclerosus is usually caused by long-term irritation and inflammation of the foreskin and head of the penis. […] This suggests that the collection of skin secretions and cells (smegma) between the foreskin and the head of the penis can lead to the irritation and inflammation that start the disease. […] Lichen sclerosus is associated with obesity, smoking and cardiovascular disease. […] There may also be a genetic component to the risk of lichen sclerosus.

• #45 Can Lichen Sclerosus be Caused by Stress

  https://coyleinstitute.com/lichen-sclerosus-and-stress/

  Lichen sclerosus (LS) is a concerning skin condition characterized by itchy and sometimes painful patches of skin around the female genitalia. […] The precise cause of LS is unknown. However, established research has uncovered hormonal, genetic, environmental, and even immune-system-response-related risk factors. […] According to a study published in 2019 in the Open Access Journal of Urology, oxidative stress (OS) plays a role in the development, pathogenesis, and progression of LS. Researchers state that DNA damage and peroxidation of the lipids caused by OS may directly contribute to the development of LS skin lesions. […] High levels of stress take a toll on the immune system over time. The stress-induced release of cortisol generates high levels of inflammatory markers in the blood. These inflammatory markers can, in turn, have a negative impact on many body systems, including the skin. Therefore, stress could very well be an underlying factor in the development of LS.

• #46 What causes lichen sclerosus? Debunking the 4 myths about the causes of VLS – Derm Nix Lab

  https://derm-nix.com/en/what-causes-the-sclerosing-liquid/?srsltid=AfmBOoppe7eUp1HdI89jOzExHp9jMkVa4yXOB-d0gvUcPiD_T4paRb8y

  Although autoimmune, hormonal and genetic factors are central to the development of vulvar lichen sclerosus, stress may also play an important role. It has been observed that emotional stress can increase disease symptoms and trigger flare-ups. Therefore, it is important to address both physical and emotional factors in the management of vulvar lichen sclerosus.

• #47 Lichen Sclerosus | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/l/lichen-sclerosus.html

  Lichen sclerosus is a long-term (chronic) skin condition. […] Experts are still working to understand what causes lichen sclerosus. It runs in families, so experts think that certain genes may play a role. […] Some factors that may lead to the condition are: Problems with your immune system, Hormonal imbalances, especially with estrogen, Past skin damage. […] You may have a greater risk for lichen sclerosus if you have an autoimmune disease, such as: Autoimmune-related thyroid disease, Autoimmune-related anemia, Vitiligo, Type 1 diabetes, Alopecia areata. […] Other factors that can increase your risk include: A history of sexual abuse, A history of the condition in your family. […] Circumcision greatly lowers the risk of lichen sclerosus in men. […] Vulvar lichen sclerosus may slightly increase the risk of squamous cell skin cancer in women. Men with lichen sclerosus on the penis may also have an increased risk. […] Untreated advanced lichen sclerosus may permanently change the look of your genitals.

• #48 What is vulval lichen sclerosus? | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/what-is-vulval-ls/

  Its important to know that LS isnt caused by an infection. Its not contagious and cant be spread through contact, including sex. […] LS can often cause white or pale patches of skin on your vulva and around your bottom. […] Over time, if it isnt treated, LS can also cause whats known as scarring or fusion, which is where parts of your vulval skin start to stick together. […] The most serious potential complication with LS is an increased risk of cancer. […] If your LS is properly treated, its thought this risk is even lower. […] LS is a long-term skin condition and, right now, there isnt a cure.

• #49 Lichen sclerosus (syn. lichen sclerosus et atrophicus)

  https://www.pcds.org.uk/clinical-guidance/lichen-sclerosis

  Lichen sclerosus (LS) is an uncommon condition characterised by white sclerotic macules and patches, commonly affecting the genital and perianal skin, although it can affect non-genital skin separately or together. LS can cause permanent scarring of the genitalia, and in approximately 5% of cases is associated with squamous cell carcinoma, mainly of the female genitalia. […] The exact aetiology is unknown. […] An autoimmune cause has been suggested as LS is commonly found alongside other autoimmune conditions. […] LS can develop after an injury to the affected area (the Koebner phenomenon). […] LS is associated with pre-malignant change and squamous cell carcinoma (SCC), which arises in 5% of patients. SCC presents mainly as a nodule, tending to arise on sclerotic tissue, especially the anterior vulva.

• #50 Lichen Sclerosus | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/l/lichen-sclerosus.html

  Lichen sclerosus is a long-term (chronic) skin condition. […] Experts are still working to understand what causes lichen sclerosus. It runs in families, so experts think that certain genes may play a role. […] Some factors that may lead to the condition are: Problems with your immune system, Hormonal imbalances, especially with estrogen, Past skin damage. […] You may have a greater risk for lichen sclerosus if you have an autoimmune disease, such as: Autoimmune-related thyroid disease, Autoimmune-related anemia, Vitiligo, Type 1 diabetes, Alopecia areata. […] Other factors that can increase your risk include: A history of sexual abuse, A history of the condition in your family. […] Circumcision greatly lowers the risk of lichen sclerosus in men. […] Vulvar lichen sclerosus may slightly increase the risk of squamous cell skin cancer in women. Men with lichen sclerosus on the penis may also have an increased risk. […] Untreated advanced lichen sclerosus may permanently change the look of your genitals.

• #51 What is vulval lichen sclerosus? | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/what-is-vulval-ls/

  Its important to know that LS isnt caused by an infection. Its not contagious and cant be spread through contact, including sex. […] LS can often cause white or pale patches of skin on your vulva and around your bottom. […] Over time, if it isnt treated, LS can also cause whats known as scarring or fusion, which is where parts of your vulval skin start to stick together. […] The most serious potential complication with LS is an increased risk of cancer. […] If your LS is properly treated, its thought this risk is even lower. […] LS is a long-term skin condition and, right now, there isnt a cure.

• #52 Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects

  https://www.mdpi.com/resolver?pii=biomedicines9080950

  This immune imbalance perpetuates an up-regulation of pro-inflammatory cytokines and, in turn, leads to a cell-mediated attack against self-antigens. […] Promoting fibroblast growth and activity, as well as abnormal collagen synthesis, is another crucial event in VLS pathogenesis and progressive formation of hyalinised and sclerotic dermal tissue. […] Several agents have been investigated as possible causal or triggering agents of LS. […] Convincing evidence is lacking but it cannot be excluded that exogenous agents can trigger immune activation and inflammation. […] The current evidence on physiopathology of VLS points towards a complex, multifactorial process. […] It is conceivable that environmental factors acting on a genetic background trigger autoimmune processes, with subsequent inflammation which, in turn, leads to tissue and microvascular injury as well as to activation of signalling pathways involved in fibroblast and collagen metabolism.

• #53 Lichen sclerosus | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/lichen-sclerosus

  The exact cause of lichen sclerosus isn’t known. It’s likely a combination of factors, including an overactive immune system, your genetic makeup, and previous skin damage or irritation. […] Lichen sclerosus isn’t contagious and can’t be spread through sexual contact.

• #54 Lichen sclerosus

  https://www.nhs.uk/conditions/lichen-sclerosus/

  The cause of lichen sclerosus is unknown. […] It might be caused by your immune system, the body’s defence against infection, mistakenly attacking and damaging your skin. […] Lichen sclerosus is: not caused by an infection […] not contagious you cannot spread it to other people through close contact, including sex […] not caused by poor personal hygiene. […] Rubbing or damage to the skin can trigger lichen sclerosus or make it worse.

• #55 Lichen sclerosus in females – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/lichen-sclerosus-in-females/

  Lichen sclerosus is a chronic inflammatory skin condition which can affect any part of the skin, but it most often affects the genital skin (vulva) and the skin around the anus. […] The cause of lichen sclerosus is not fully understood. It can be associated with other diseases in which the bodys immune system attacks normal tissues such as the thyroid gland (causing an overactive – or underactive thyroid gland) or the insulin-producing cells in the pancreas (causing diabetes), but it has not been proven that it is an auto-immune condition in itself. […] Lichen sclerosus is not due to an infection the disease is not contagious and cannot be spread through contact, including sexual intercourse. It is not related to allergy or hormonal abnormalities. […] It is not known if lichen sclerosus is hereditary, but it rarely occurs in relatives.

• #56 Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets

  https://www.ijbs.com/v15p1429.htm

  Despite the strong association with autoimmune disease, the etiology of LS remains a large mystery. […] However, potential therapeutic targets in recent years have been implicated in LS pathology and these emerging targets are discussed below and may be further categorized based on their functional roles in LS pathogenesis and progression via their involvement in (1) activating autoimmunogenic mechanisms, (2) inducing sclerotic tissue formation, or (3) triggering oxidative stress. […] In addition to ECM1, aberrant expression of various immune and genetic targets has been implicated in the pathogenesis of LS that are either involved in inducing an immunogenic mechanism and/or modulating fibroblast activity and collagen homeostasis. […] Nevertheless, these markers serve as potential therapeutic targets that warrant further study and analysis in order to uncover the true onset and course of disease progression.

• #57 Lichen sclerosus: An overview – Medical Independent

  https://www.medicalindependent.ie/clinical-news/lichen-sclerosus-an-overview/

  Chronic irritation and microtrauma to the affected skin have been proposed as potential triggers for lichen sclerosus, especially in the anogenital region. […] In some cases, infections, such as human papillomavirus (HPV), have been suggested as possible triggers for lichen sclerosus. […] Further research is needed to determine the exact aetiology of lichen sclerosus and explore novel treatment modalities.

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