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Common skin conditions
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For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately five minutes to complete. There is a list of suggested further reading material at the end of the quiz.
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What is the diagnosis?
Lichen sclerosus.
Where else should you specifically examine and why?
The patient should be fully examined looking for other affected areas, and associated skin conditions. Lichen sclerosus often affects the genitals particularly the vulva of postmenopausal women. They may not volunteer the information, but often suffer from severe pruritus, dyspareunia or vulvodynia, which could be relieved by effective treatment. The clinical diagnosis should be confirmed by a dermatologist. A biopsy is sometimes necessary. There are associations with lichen planus and morphoea (localised scleroderma).
Which treatments are used for this disorder?
Unfortunately no treatment has consistently been found to be useful for cutaneous lichen sclerosus. Ultrapotent topical steroids are usually effective for lichen sclerosus affecting the genitals. Accurate diagnosis and management should be supervised by a consultant dermatologist.
Does the skin condition have any complications?
Lichen sclerosus of the vulva may rarely be complicated by squamous cell carcinoma. This is much less likely on non-genital sites.