What is Lichen Sclerosus?
Write to Karl Loren -- he will answer
[Karl
Loren Note: It may, sometimes, be true that a drug
is the best treatment. I start my advices with a
preconception that there will always be something better
than a drug. In this case my advice is similar to
what it is for other so-called "hopeless diseases."
I
recommend a
change in diet, a
detoxification of the body, and an examination of the
wrong relationships in the person's life.
Actual "treatments" should be done after these three
senior factors are explored. I would then suggest
topical and internal usage of MSM, including MSM
cream, called
Calm Cream and
Life Glow Basic.
The creator of Calm Cream lives in India. He is an Ayruvedic physician who reads the ancient Sanscrit texts from the Ayruveda. He is also a homeopathic doctor and regularly treats patients with both skills.
He is the owner of the factory that makes the MSM sold by Vibrant Life. He received a question about using MSM and MSM Cream (Calm Cream) for this skin condition.
The question indicated that the person asking had done a great deal of research on this skin problem. She asked certain questions about the proprietary nature of Calm Cream.
His answer provides valuable data about treatment. Click Here for that information on this page, below.
I believe
that the above protocol will handle this situation
completely.
___________________________________________________________________________
While I am unable to reveal or confirm the source of my Wax (as a rule for protecting our trade secrets) -- I can only assure you that -- you need to have no worries on that account.
Our CalmCream does not contain any chemical preservatives whatsoever. CalmCream has been successfully used with excellent results even for new born babies facing difficult skin problems in the initial days & weeks of their life. Hence you may use CalmCream with absolutely free mind -- without any worry for any kind of unpleasant reactions. All active ingredients in CalmCream are individually edible.
We also make a product called "Herbal MSM", which contain concentrated Ayurvedic Herbal Extracts along with Pure MSM. I suggest that you use our Herbal MSM with a dosage of 6 - 10g a day splitting to 2 doses -- once in the morning & once at night.
One precaution that is needed while taking Herbal MSM is -- that it should not be mixed with any aerated soft drinks or canned juices which contain chemical preservatives.
You may mix Herbal MSM with Pure Water or any Fresh Fruit Juice, and then slowly sip the juice allowing thorough mixing with saliva to allow activation of natural enzymatic reaction. You will experience dramatic results with Herbal MSM which will be long lasting compared to just Pure MSM.
You can get your supplies of Herbal MSM from my Partner / Agent in USA. A copy of this mail is going to my Partner -- Mr. Karl Loren,
Ayyangar
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________________________________________________________________________________________
Note
Lichen Planus and Lichen Scherosus are virtually the
same.]
Lichen Sclerosus
Photo
What
is Lichen Sclerosus?
Child sexual abuse enquiries and unrecognised vulval
lichen sclerosus et atrophicus
Lichen Planus
Source
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Background
Lichen sclerosis et atrophicus (LSEA)
is a relatively common skin condition. It is more
common in women, commonly found on genital skin.
Itching and soreness are common findings. There may be
an association with autoimmune diseases.
| TREATMENT |
Potent topical
steroid ointment (clobetasol proprionate 0.05%) daily
for 3 months is the treatment of choice for vulvar LS
at all ages
[Karl Note: This is the usual drug approach and will prove to be harmful to anyone who uses it. The proper treatment is described above.] |
Source
Dept. of Dermatology - University of Iowa College of Medicine
Lichen Sclerosis et Atrophicus (LS&A) - Peri-umbilical Abdominal Skin Fold
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Source
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Lichen Sclerosus
By
Dr Rob Hicks
What is Lichen Sclerosus?
Is it easy to
diagnose?
How are people affected?
How do you treat it?
If it's estimated that a disease
affects up to one in three people around the world you
would expect to have heard about it, wouldn't you?
Perhaps it's because people feel embarrassed, perhaps
it's because it's not often diagnosed correctly, perhaps
it's because it's difficult to treat? Whatever the reason
Lichen Sclerosus exists and causes misery for many.
What is Lichen Sclerosus?
Return To Top
Lichen Sclerosus is
a skin condition that causes inflammation and often
intractable itching for long periods of time. Most
commonly it affects the skin around the genital and anal
areas. There's actually very little known about it
considering it was first reported over a hundred years
ago in 1887.
It's estimated to
affect up to one in 300 people around the world, the
majority of these people being women over the age of
fifty. Men are much less often affected than women and
occasionally children develop it too but this isn't
common.
At present there is
still much speculation around what exactly causes Lichen
Sclerosus. Many theories have been put forward suggesting
that there's a genetic susceptibility and that infection
may trigger its development. There also appears to be a
link with other auto-immune conditions, for example
thyroid disease. However, none of this is carved in
stone.
Since Lichen Sclerosus affects such
a sensitive area of the body it's important to point out
that it's not infectious, not sexually transmitted, and
nothing to do with poor hygiene.
Is it easy to diagnose?
Return To Top
Sadly many people may suffer the
traumatic symptoms of Lichen Sclerosus for months,
sometimes years, before it's correctly diagnosed. Making
the diagnosis is not easy and often it's thought to be
eczema or thrush and treated as such. If vulval itching
is present for over a year then the opinion of a
dermatologist should be sought. It's here that the
diagnosis can be reliably made by taking a biopsy under
local anaesthetic in the hospital outpatients'
department. 
How are people affected?
Return To Top
|
Lichen sclerosus facts |
| 1.
Affects up to 1 in 3 people
2.
Cause unknown
3.
Women affected more than men
4.
Genital area / anal area most affected
5.
Women sufferers need screening for vulval cancer
6.
Symptoms best controlled with steroid creams
7.
Damaged skin prevents normal sexual intercourse,
bowel opening, and urination
8.
Causes chronic itching and discomfort
9.
No cure |
Some people have the condition and
suffer no symptoms at all. Many however suffer agonising
itching and discomfort.
Women are affected most often around
the vulva where the skin becomes white and thickened. It
scars making the vulva shrink in size and the vagina
tightened. This makes having sexual intercourse extremely
difficult and painful and many women describe how they
have to put up with an "enforced celibacy".
Similar effects occur around the
anus. This makes normal bowel opening uncomfortable,
often resulting in small tears which can be exquisitely
sore.
Whether these damaged areas are
scratched or not they are often accompanied by blisters
and sores that are susceptible to the further problems of
infection and thrush.
For men it's the tip of the penis
that is most often affected. It too becomes firm and
white and narrowing of the urethral opening makes passing
urine difficult. Men may describe passing a very thin
stream of urine.
With symptoms of chronic itching and
discomfort, the effects Lichen Sclerosus has on people's
sex lives, and the fact that there's no cure, it's not
surprising that some people also become depressed as a
result of their on-going problem.
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It can also affect other parts of
the body too. Although this doesn't happen often when it
does it's usually the upper back and shoulders where it
appears. The white spots look like tissue paper and feel
waxy to the touch.
How do you treat it?
Once the diagnosis is made many
people describe feeling somewhat better in themselves.
Feeling that at last they've been taken seriously, that
their problem is real and not in their mind as some may
have believed, and that something can be done to
alleviate their symptoms. This helps to create a positive
attitude which is an essential part of treatment for
chronic diseases such as this.
The mainstay of treatment is the use
of steroid creams, which are used initially for a period
of three months and then used as needed. Moisturising
creams help soothe the skin and sometimes anaesthetic
creams or gels are beneficial. Healthy skin needs
vitamins C and E, and zinc, so the diet should be
abundant in these.
[Karl Note: This is the usual drug approach and will prove to be harmful to anyone who uses it. The proper treatment is described above.]
Antibiotics are needed when
infection is present and anti-fungal treatments for
thrush.
Although Lichen Sclerosus is said to
resolve spontaneously after a number of years it tends to
cause physical damage in the meantime. This damage often
needs repairing with surgical operations. Vulva cancer is
more common in women with Lichen Sclerosus and for this
reason it is recommended that they are seen by a
specialist every year or so.
| |
Source
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Child sexual abuse
enquiries and unrecognised vulval lichen
sclerosus et atrophicus
P L Wood and T Bevan Find that unrecognised
vulval dystrophy in young girls may wrongly
suggest childhood sexual abuse
Lichen sclerosus et atrophicus in young
girls can present as haemorrhagic areas on the
vulva. Failure to consider this diagnosis and to
treat the condition appropriately may lead to a
mis diagnosis of child sexual abuse, resulting in
a lengthy and distressing investigation for all
concerned, particularly the parents. There was
extensive publicity surrounding these issues in
the United Kingdom after events in Cleveland in
1987. We present three patients with lichen
sclerosis et atrophicus. In each case,
investigations into child sexual abuse had been
instigated before an appropriate referral and
correct diagnosis were made.
Case reports
Case 1
A 6 year old girl was admitted to hospital as an
emergency under the care of the pae diatricians.
There was a history of a suspected accidental
fall, after which the girl's mother noticed blood
staining on her daughter's underwear. The girl
lived with her mother and her mother's partner
and visited her natural father once a week.
The local social services department had
already been involved about six months previously
because of a history of suspected, unexplained
perineal trauma. At that time, after a visit to
her father, the girl had complained of soreness
around the vulva, and a brown discharge had been
noticed on her underwear. The girl's mother had
described continuing vaginal ulceration which did
not heal completely. The symptoms had persisted
despite antibiotic treatment, acyclovir for
suspected genital herpes simplex infection (which
prompted further investigation because of the
association with child sexual abuse), and
reassurance. The child protection investigations
had proved inconclusive, and the child's mother
had been particularly upset at the failure to
define the problem.
Physical examination in hospital showed two
bruises less than 0.5 cm in diameter on the left
labia minora, a transverse tear of the upper part
of the clitoris, a superficial skin laceration
between the labia minora and labia majora, and
two scratch marks on the right labia minora. The
findings were considered to be accidental, but
the girl's mother remained concerned by the fact
that there was no resolution to a condition that
had been continuing for some months, and a
gynaecological opinion was sought.
The girl attended a paediatric gynaecology
clinic. A history of vulval soreness spanning one
year was elicited. Clinical examination showed
findings compatible with lichen sclerosus et
atrophicus that is, ivory or white areas of
hypopigmentation (often affecting vulval and
perianal areas in a figure of eight pattern); a
tendency to fine wrinkling; and areas of bruising
or blistering (figure). Topical treatment with 1%
hydrocortisone cream was begun, to good effect.
Anaerobic bacteria were cultured on vaginal
swabs, and this infection was treated with
metronidazole. The girl's symptoms improved with
the treatment, and the vulval dystrophy resolved.
Because social services had been involved with
the case, they were notified about the diagnosis
(with the Mother's consent).
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Typical vulval changes of
lichen sclerosus et atrophicus in a young
girl |
Case 2
A general practitioner telephoned the paediatric
gynaecology clinic about a patient- a 6 year old
girl whose condition might be explained by "abuse
of some sort." He had identified bleeding from
the labial area and at follow up had noticed
bruising of the labia and introitus.
Return To Top
The girl attended the paediatric
gynaecology clinic with both parents. She had
complained of soreness on one occasion only-while
being dried after a bath supervised by her
father, who had noticed redness of the vulva. The
girl had no other symptoms. Physical examination
showed some clitoral oedema, bilateral bruising
of the labial edges, and an overall pale
appearance. She had continued to have
intermittent vulval bruising despite antifungal
cream prescribed by the general practitioner and
a course of metronidazole for an infection of
anaerobic organisms cultured on a vaginal swab.
The abnormal vulval appearances resolved after a
course of 1% hydrocortisone cream, initially
applied twice daily.
Case 3
A 4 year old girl with a history of vulval
infections over the previous 9-10 months was
referred to the paediatric gynaecology clinic by
her general practitioner. The infections had been
associated with bruising and a "blood blister,"
and her family had wondered about the possibility
of sexual abuse to the extent that her father had
telephoned social services for help and advice.
The parents had noticed that their daughter had
been lying on top of her teddy bear and rubbing
herself. She had had several episodes of these
symptoms, which were treated with courses of
antibiotics. The girl's general practitioner
remarked that she had been shocked by the vulval
redness, inflammation, bruising, and ulceration.
The child's parents were anxious and distressed
and requested a further opinion.
Physical examination at the paediatric
gynaecology clinic showed the typical changes of
lichen sclerosus et atrophicus. The girl was
treated successfully with 1% hydrocortisone
cream.
Comment
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Lichen sclerosus et atrophicus generally
affects the anogenital region. It is most often
found in women but is also seen in young girls
and was first reported in young girls about 30
years ago.1 Because the condition is
uncommon before puberty, however, general
practitioners and paediatricians who have not
come across lichen sclerosus et atrophicus in
children may have a low index of suspicion and
may fail to recognise the typical appearances.
This lack of awareness persists despite recent
reports highlighting the existence of the
condition in children and noting confusion with
regard to the misdiagnosis of childhood sexual
abuse, of which there is an increased general
awareness.2,3
The symptoms of itching and soreness can be
troublesome, and a young child may try various
ways of obtaining relief, some of which may be
mistakenly interpreted as masturbatory behaviour.4
Masturbation is not uncommon in children,5
but rubbing may lead to concerns over possible
sexual abuse if it is perceived as inappropriate
childhood behaviour.
The appearances of lichen sclerosus et
atrophicus include localised haemorrhages
(figure).6 A clue to the true
diagnosis is the delineation of thinned skin,
which gives a well demarcated parchment-type
appearance, often in an hourglass shape.
The presence of lichen sclerosus et
atrophicus may, in itself, increase the
susceptibility to trauma, since the skin becomes
thin and easily damaged. As a result, the effect
of minor injuries may be magnified-for example,
wiping with toilet tissue may cause bruising.3
Return To Top
Vulval bruising, which is not always
accompanied by the more typical symptoms of
lichen sclerosus et atrophicus such as soreness
or pruritus, can raise suspicions of possible
childhood sexual abuse. These suspicions warrant
an appropriate investigation, which can be
upsetting for all concerned. Failure to recognise
that the underlying changes are caused by lichen
sclerosus et atrophicus, and to treat these
accordingly, can therefore lead to inappropriate
investigations. Nevertheless, the condition and
sexual abuse may coexist. Hymenal trauma is an
important marker in helping to determine whether
sexual abuse has occurred, regardless of the
presence of lichen sclerosus et atrophicus.7
Expert diagnosis is necessary to ensure a correct
diagnosis, relevant further investigations, and
treatment (box).
Return To Top
Differential diagnoses
- Lichen sclerosus et
atrophicus
- Vulvovaginitis
- Psoriasis
- Eczema
- Contact dermatitis
- Sexual abuse
- Trauma
- Systemic illness (for
example, Stevens-Johnson syndrome)
|
All the families concerned in these cases
were greatly relieved when the correct diagnosis
was identified. There was also a degree of upset
and resentment that a child sexual abuse inquiry
had unnecessarily been initiated because of a
failure to recognise the underlying disorder. The
misdiagnosis of lichen sclerosus et atrophicus in
young girls remains a problem. Despite previous
published reports, general practitioners and
paediatricians are still failing to consider the
diagnosis or recognise its typical appearances.
Contributors: Both authors were involved in the
care of the patients. TB carried out the
literature searches; PLW wrote the paper and will
be guarantor.
Return To Top
P L Wood consultant
T Bevan paediatric nurse
Paediatric and Adolescent Gynaecology Clinic,
Kettering General Hospital NHS Trust, Kettering
NN16 8UZ
- Clark JA, Muller SA. Lichen sclerosus et
atrophicus in children. Arch Dermatol
1967;95:476-82.
- Handfield-Jones SE, Hinde FRJ, Kennedy
CTC. Lichen sclerosus et atrophicus in children
misdiagnosed as sex- ual abuse. BMJ
1987;294:1404-5.
- Bays J, Jenny C. Genital and anal
conditions confused with child sexual abuse
trauma. Am J Dis Children 1990;144:1319-22.
- Levene MI, ed. Jolly's diseases of
children. 6th ed. Oxford: Blackwell Scientific,
1991.
- Hull D, Johnston D, eds. Essential
paediatrics. 3rd ed. Edinburgh: Churchill
Livingstone, 1993.
- DiSilverio A, Serri F. Generalised
bullous and haemor- rhagic lichen sclerosus et
atrophicus. Br J Dermatol 1975;93:215-7.
- Warrington SA, de San Lazaro C. Lichen
sclerosus et atrophicus and sexual abuse. Arch
Dis Child 1996;75:512-6.
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Source
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Vulval lichen sclerosus
and lichen planus
The CancerBACUP Factsheet |
|
|
This factsheet has been written
to give you information about two particular skin
conditions, lichen sclerosus and lichen planus,
which can affect the vulva and may occasionally
develop into cancer after many years. Only a
small number of women with lichen sclerosus or
lichen planus (around 3-5%) will develop a vulval
cancer. This factsheet discusses these conditions
and their treatments.
If you would like further information
please phone CancerBACUP's Cancer Support Service
on 020 7613 2121 or Freephone 0808 800 1234 and
speak to one of the specialist cancer nurses.
The vulva
The vulva is the term that describes a
woman's external genital area. It includes two
large, hair-covered folds of skin called the
labia majora, which surround two thin and
delicate folds called the labia minora. The labia
majora and labia minora surround the opening of
the vagina (birth canal) and the urethra (the
tube through which urine is passed). The clitoris
is positioned above the vagina and urethra: this
small structure is very sensitive and helps a
woman to reach sexual climax (orgasm). The anus
(opening to the back passage) is separated from
the vulva by an area of skin called the perineum.
What are vulval lichen
sclerosus (LS) and lichen planus (LP)?
LS and LP are fairly common, non-cancerous
skin conditions, which can occur in the skin on
any part of the body. They can affect children as
well as adults. These changes are not cancer, but
in a few people they may, over many years,
develop into a type of skin cancer known as
squamous cell cancer. In vulval LS and LP changes
occur in the skin of the vulva. It is a slowly
developing, inflammation of the skin in the
vulval area which can be controlled by treatment,
but cannot be cured.
Causes of lichen sclerosus
and lichen planus
The causes are not known, but some women
with these conditions have other family members
with LS or LP. They are more common in older
women, and in women who have auto-immune
illnesses such as thyroid problems or pernicious
anaemia. It is not possible to get LS or LP
through sexual intercourse: neither are sexually
transmitted disease and they are not infectious.
Signs and symptoms
The skin in the affected areas is very
itchy and sore, with an abnormal appearance and a
change in colour. The skin becomes more fragile
than normal skin and may split, causing stinging
and pain. The vulva may become distorted, causing
a change in the shape or size. Occasionally this
leads to difficulties with passing urine or
having sexual intercourse. The vagina may become
narrowed and sexual intercourse may become
uncomfortable. The symptoms vary from woman to
woman and some women with these conditions have
no symptoms at all. In this case the conditions
may be discovered during medical examinations for
other health problems.
The above symptoms can be caused by
conditions other than LP or LS. If you have any
of the above symptoms, let your doctor know. Your
doctor can then examine you and refer you to a
doctor who specialises in women's health (gynaecologist).
Return To Top
How is it diagnosed?
As the signs and symptoms of LS and LP can
vary and are similar to other conditions of the
vulva, it is necessary to take a small sample of
cells from the affected area to examine under a
microscope. This is known as a biopsy and is done
in the out-patient department. An anaesthetic
cream is usually used to numb the vulval area
before the biopsy is taken and it takes 20
minutes to work. Local anaesthetic is then
injected into the area, using a small needle.
Sometimes a general anaesthetic may be given. A
sample of cells (about the size of a peppercorn)
is then taken from the vulva, using a biopsy
tool.
Treatment
Return To Top
Often no treatment will be needed, but if
you have severe LS or LP you will need to see
your doctor regularly. If the symptoms such as
itching or soreness begin to become troublesome,
it can help to use a non-perfumed moisturiser
instead of soap in the vulval area. A type of
steroid ointment (clobetasol proprionate, called
Dermovate) can be prescribed by your doctor and
is often used twice a day for 3 months. After
this your doctor may recommend you to use the
cream twice a week. This treatment is safe, can
often control the symptoms very well, and can
help women go back to a normal life, but it will
not get rid of the condition completely. The
treatment can make the skin more supple and so
can help to make intercourse easier.
[Karl Note: This is the usual drug approach and will prove to be harmful to anyone who uses it. The proper treatment is described above.]
Rarely, the lichen sclerosus or lichen
planus can cause a skin ulcer or sore which does
not heal and laser surgery may then be used to
remove the affected areas of skin. The laser
surgery is usually done in the outpatients
clinic. Your doctor can tell you how much skin
will need to be removed and how this may affect
you. It is important to discuss this with your
gynaecologist before you have the treatment.
Follow-up
Return To Top
As lichen sclerosus or lichen planus are
long term conditions which cannot be completely
cured you will be seen by your specialist
regularly, as they may continue to cause
symptoms. Women who have had either of these
conditions for many years have a small risk of
developing a vulval cancer. This usually occurs
in women in their 60's to 90's rather than in
younger women. It is important to see your doctor
or nurse regularly to check for any signs of a
cancer developing so that treatment can be given
at an early stage when there is a high chance of
cure.
Your feelings
Many women feel frightened when they are
first told that they have lichen sclerosus or
lichen planus, and worry that they may develop
cancer. You may find the treatments embarrassing
and frightening, and may feel tense, tearful, or
withdrawn. At times these feelings can be
overwhelming and hard to control. Everyone has
their own way of coping with difficult
situations. Some people find it helpful to
talk to friends or family, while others
prefer to seek help from people outside their
situation. Others may prefer to keep their
feelings to themselves. There is no right or
wrong way to cope, but help is available if you
need it.
Useful organisations
National Lichen Sclerosus Support Group
2 Ivy House, Wantage Road, Great Shefford
Berkshire RG17 7DA
Website:
www.lichensclerosus.org
Provides emotional support and general
information on a one to one basis (initially by
letter - please send SAE). Some telephone support
can be arranged by arrangement thereafter.
The Vulval Pain Society
PO Box 514, Slough, Berkshire SL1 2BP
Website:
www.vul-pain.dircon.co.uk
A voluntary organisation run by a doctor and
nurse, the society gives information and support
to women with any vulval condition. Membership is
£10 per year. It has a newsletter which gives
members a chance to share their experiences,
liaise with other women, and ask questions
relating to vulval conditions. Non-members making
enquiries should enclose an SAE.
For more information call CancerBACUP's
Cancer Support Service on 020 7613 2121 or
Freephone 0808 800 1234 to speak to a cancer
specialist nurse. Lines are open Monday-Friday,
9am-7pm.
Return To Top
This factsheet has been
compiled using information from a number of
reliable sources including the Oxford Textbook of
Oncology, Souhami and Tobias and The Textbook of
Uncommon Cancers. Each CancerBACUP factsheet is
regularly reviewed and updated by cancer doctors,
specialist nurses, other relevant health
professionals and people with cancer.
Last reviewed/updated:
December 2001
© CancerBACUP 2001, DCIS.
All rights reserved. No part of this publication
may be reproduced or transmitted, in any form or
by any means, electronic or mechanical, including
photocopying, recording, or any information
storage and retrieval system, without permission
in writing from CancerBACUP. British Association
of Cancer United Patients, 3 Bath Place,
Rivington Street, London EC2A 3JR. Charity
Registration No. 1019719. A company limited by
guarantee. Registered in England and Wales.
Company No. 2803321. Registered office as above.
© CANCERBACUP 2001 VULVAL LICHEN SCLEROSUS
AND LICHEN PLANUS. All rights reserved. No parts
of this publication may be reproduced or
transmitted, in any form by any means, electronic
or mechanical, including photocopying, recording,
or any information storage an retrieval system,
without permission in writing from CancerBACUP, 3
Bath Place, Rivington Street, London, EC2A 3JR.
Charity Registration No.1019719. A company
limited by guarantee. Registered in England and
Wales. Company No. 2803321. Registered office as
above. |
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His personal philosophical articles are at PHILOSOPHY.
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