Lichen simplex, Lichen sclerosis & Lichen planus

Definition:

Lichen Simplex - this presents as a localised demarcated plaque usually with scaling, excoriations and lichenification (increased skin markings and thickened skin) on the surface. The lesion is particularly itchy. Common sites are the calf, elbow, behind neck and genitalia (vulva or scrotum). Plaques are usually greater than 5cm in diameter.

Lichen sclerosus is a chronic inflammatory skin disorder that can affect men, women, or children, but is most common in women. It usually affects the vulva and the anal area. While lichen sclerosus appears predominantly in postmenopausal women, this skin condition is also known to develop on the head of the penis, almost exclusively in uncircumcised men. Occasionally, lichen sclerosus is seen on other parts of the body, especially the upper body, breasts, and upper arms.

Lichen planus - thought to be an auto-immune disease which can affect the skin, oral or genital mucosa and more. It causes an eruption of shiny flat-topped purplish (usually itchy) papules.

Mr Stefan Chmelik on Lichen simplex, Lichen sclerosis, lichen planus

Although similarly names, these three conditions are in fact quite different and distinct.

Simplex is an area of itching skin, and the inevitable scratching become part of the problem in itself, perpetuating the condition unless the cycle is broken. Treatment is focused on relieving itching and reducing the stress involved with this problem.

Sclerosus does not have a clear cause conventionally, although it is thought to have an autoimmune component as around 25% of people with lichen sclerosus have another auto-immune disease such as thyroid disease, vitiligo, or pernicious anaemia. Treatment is mostly with herbal medicine, which addresses both the itching as well as the immune system.

Planus in Chinese Medicine terms is a disease that is due to an imbalance of the Liver , Spleen or Kidneys. Treatment is again predominantly herbal, with the prescription depending on the organ involved. Dietary therapy and acupuncture may also be useful