Lichen sclerosus: causes, diagnosis and treatment

1.General information

Sclerosing (scleroatrophic) lichen/lichen of the vulva, also kraurosis of the vulva, guttate scleroderma, etc. – a slowly progressive degenerative process in the skin and mucous membranes of the female external genitalia. The disease was first described at the end of the 19th century by the Austrian gynecologist August Brysky (1885) and the French dermatologist Francois Henri Allopeau (1887).

Currently, the incidence is estimated at 1.7% among adult women and less than 1% among prepubescent girls. This division of epidemiological indicators is necessary due to the fact that in medical statistics there are two clear age-related surges in incidence - one is noted in samples with an average age of 5.5 years, the other in the postmenopausal period (average age is about 55 years). According to domestic sources, the share of degenerative-dystrophic diseases of the vulva accounts for from 0.5% to 9% of all gynecological pathologies taken into account; there is a steady tendency towards an increase in this proportion, and this trend concerns lichen sclerosus to the greatest extent.

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Leading specialists in the treatment of lichen sclerosus of the Southern Federal District

Ermolaeva Elvira Kadirovna is a well-known and recognized specialist in the North Caucasus in the field of diagnosis and treatment of kraurosis, leukoplakia, lichen sclerosus, Keir's erythroplasia and other diseases of the vulva. A good gynecologist, physiotherapist-resortologist, ultrasound doctor. Desperate and exhausted women turn to her.

Ermolaev Oleg Yurievich Candidate of Medical Sciences, gynecologist-endocrinologist with 25 years of experience and successful experience in treating lichen. Able to see relationships that elude others.

About the doctors of the Clinic in detail...

INTERNATIONAL RECOGNITION of the reputation and achievements of the Women's Health Resort Clinic in the development and implementation of effective and safe treatment methods and the quality of medical services provided is the AWARDING of the Women's Health Resort Clinic in Pyatigorsk with the SIQS International QUALITY CERTIFICATE in the field of medicine and healthcare. International Socratic Committee, Oxford, UK and Swiss Institute for Quality Standards, Zurich, SWITZERLAND.

The resort clinic for women's health operates both for paid services and in the voluntary health insurance system.

Each doctor at the Clinic has long-term experience, several specializations and is able to comprehensively assess the situation.

The resort women's health clinic is open 7 days a week and on holidays:

Monday - Friday from 8.00 to 20.00, Saturday, Sunday, holidays from 8.00 to 17.00.

Treatment by appointment no later than 3 days in advance by multi-channel phone number 8 (800) 500-52-74 (calls within Russia are free), or +7 (for international calls).

ONLINE information about the treatment of lichen in Pyatigorsk can be found at

REGISTER ONLINE for treatment here.

REGISTER online for treatment here.

You can buy coursework for treatment by phone or here.

Booking

The doctors of the Women's Health Resort Clinic have gained a LOT of successful EXPERIENCE in treating lichen with natural medicines and resort factors.

We accept women from all cities of Russia, near and far abroad.

The spa clinic for women's health facilitates the accommodation and accommodation of women, women with children and couples during examination and treatment.

ACCOMMODATION in Pyatigorsk is NOT INCLUDED IN THE PRICE of the course of treatment for lichen and is paid separately.

About living conditions and transfer from Mineralnye Vody airport and Pyatigorsk railway station in detail in the article “Accommodation”.

If you need to book accommodation, please coordinate your arrival date no later than 7 days in advance.

We are AT YOUR FULL DISPOSAL if you have any doubts or wishes.

  • About the Clinic
  • Clinic team
  • Reviews about treatment in our Clinic
  • What is homeopathy?
  • How to prepare for an appointment with a gynecologist?

Our Lichen Treatment Clinic is open 7 days a week and on holidays:

Monday - Friday from 8.00 to 20.00, Saturday, Sunday, holidays from 8.00 to 17.00.

Treatment by appointment via multi-channel telephone number 8 (calls within Russia are free), or (for foreign calls).

ONLINE about the treatment of lichen in Pyatigorsk at [email protected]

BOOK ONLINE for treatment here.

Buy coursework for treatment by phone or here.

Booking a course

Subsections

  • Program No. 1. Treatment of inflammatory and infectious diseases of the pelvis
  • Program No. 2. Treatment of urinary incontinence, prolapse and prolapse of the uterus and vagina
  • Program No. 3. Treatment of female infertility
  • Program No. 4. Treatment of erosion, endometriosis, leukoplakia, dysplasia, polyps, cervical cysts (uterine cysts)
  • Program No. 5. Treatment of uterine fibroids
  • Program No. 6. Treatment of cervicitis and endocervicitis
  • Program No. 7. Postpartum rehabilitation and wumbling
  • Program No. 8. Treatment of chronic cystitis
  • Program No. 9. Treatment of severe menopause
  • Program No. 10. Treatment of mastopathy
  • Program No. 11. Treatment of endometriosis
  • Program No. 12. Treatment of hydrosalpinx
  • Program No. 14. Comprehensive treatment of polycystic ovary syndrome
  • Program No. 15. Preconception preparation for IVF, ICSI
  • Program No. 16. How to remove belly fat
  • Program No. 17. Treatment of kraurosis
  • Program No. 18. Treatment of leukoplakia

2. Reasons

The etiopathogenesis of vulvar lichen sclerosus has not been well studied and remains unclear. The multifactorial, polyetiological nature of the disease is assumed; Probably, the role of the trigger is played by one or another combination of the following factors:

  • hereditary predisposition;
  • immunopathological conditions;
  • non-compliance with the rules of intimate hygiene, a tendency to excessively insulate the genital area;
  • endocrine and metabolic disorders, obesity;
  • emotionally labile, neurotic, depressive and other mental disorders, stress, psychotrauma;
  • the presence of various types of herpesvirus and human papillomavirus;
  • chronic and frequent bacterial vulvovaginitis;
  • surgical interventions on the female reproductive system;
  • injuries to the vulva (mechanical, including those received during rape, as well as chemical and thermal).

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3. Symptoms and diagnosis

The most typical manifestations of lichen sclerosus of the vulva include swelling and hyperemia of the labia, burning, itching, and in girls often ulcers and petechiae. At later stages - thinning, dryness, loss of turgor of the skin and mucous membranes, change in shade to waxy yellowness or cyanosis. In many cases, spontaneous genital hair loss occurs. The atrophic process gradually involves the clitoris, perineum, perianal zone, etc. Cicatricial changes, atrophic wrinkling, pale wrinkled plaques, and local marble-white depigmentation are observed. Over a long period of time, the entrance to the vagina sharply narrows and the clitoris atrophies completely. Girls have signs of scratching, spontaneous hemorrhages, scars, etc. are often perceived by parents as signs of experienced sexual aggression.

It should be especially emphasized that kraurosis is a precancerous condition: the risk of malignancy in lichen sclerosus reaches, according to some estimates, 25-35%.

The diagnosis is established clinically and histologically (biopsy). The search and identification of pathogenic fungal and bacterial flora, viruses, and autoimmune antibodies is carried out. Symptomatically similar diseases (lichen planus, vitiligo, neurodermatitis, etc.) are excluded.

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Prognosis for lichen sclerosus

Lichen sclerosus is a PRIMARY CHRONIC DISEASE with an imperceptible period of formation and a long course.

In most cases, lichen is incurable and SLOWLY PROGRESSES throughout life, BECAUSE most women categorically DO NOT WANT TO RETHINK themselves and look at life and themselves in this life in a new way.

Based on our long and successful experience in the treatment of lichen sclerosus, after eliminating the causes of lichen sclerosus and adequate comprehensive treatment, it is POSSIBLE to achieve and MAINTAIN a state of stable remission (a state WITHOUT COMPLAINTS and subjective changes).

4.Treatment

There is no consensus yet regarding the optimal therapeutic strategy for vulvar lichen sclerosus. As a rule, they begin by eliminating all irritating and provoking factors that can be controlled (see above). Various combinations of anti-inflammatory hormonal drugs, immunomodulators, estrogens (in the form of ointments or creams), desensitizing drugs, sedatives, tranquilizers, various physiotherapeutic procedures, etc. are used. Already from the composition of the above, it is clear that the prescriptions are more empirical in nature and/or based on intuition, rather than on a clear theoretical and methodological basis, which is yet to be formed in the course of future research and clinical trials.

In the most severe cases, surgical correction is resorted to (minimally invasive cryodestruction or laser ablation, or resection followed by plastic surgery; the latter is preferable in terms of preventing malignancy).

Reasonable restrictions for lichen sclerosus

Lichen sclerosus requires simple but important restrictions even after achieving remission during treatment at the Women's Health Resort Clinic.

If you have lichen, it is EXTREMELY UNDESIRABLE to take hot general baths, stay in the sun for a long time and sunbathe (regardless of the activity of the Sun, the presence/absence and type of bathing suit).

Thermal procedures and insolation (sunbathing in natural conditions and solariums) increases the production of estrogens (female sex hormones), the excess of which stimulates oncological processes.

Reviews about the treatment of lichen sclerosus

Kh.M., Nazran

I am so glad that I found you, you are such a kind, good, bright person. I tell everyone about you. And they also ask me what I found there in this Pyatigorsk. I answer, “I found myself a doctor.” Thank you very much for everything, happiness, health and all the best.

V.E., Kislovodsk

Thank you for the treatment you provided me. I wish you success and prosperity! It is very rare to find such professionalism. Your staff is very pleasant, the atmosphere fills with good emotions. Thank you for your health!!!

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