Lichen sclerosus and lichen simplex chronicus are two skin conditions that result in skin irritations and patches. Both these conditions mainly affect females, though they can be seen in men as well.
The key difference between lichen sclerosus and lichen simplex chronicus is their cause. Lichen sclerosus is an autoimmune skin condition that causes itchy, white patches on the genitals or other parts of the body, while lichen simplex chronicus is a non-autoimmune skin condition that causes thickening of the skin with variable scaling, which arises secondary to repetitive scratching or rubbing on areas like head, neck, arms, scalp, and genitals.
CONTENTS
1. Overview and Key Difference
2. What is Lichen Sclerosus
3. What is Lichen Simplex Chronicus
4. Similarities – Lichen Sclerosus and Lichen Simplex Chronicus
5. Lichen Sclerosus vs Lichen Simplex Chronicus in Tabular Form
6. Summary – Lichen Sclerosus vs Lichen Simplex Chronicus
7. FAQ – Lichen Sclerosus and Lichen Simplex Chronicus
What is Lichen Sclerosus?
Lichen sclerosus is an autoimmune skin condition that causes patchy, discolored, thin skin in areas such as genital and anal areas. Postmenopausal women are at higher risk of getting lichen sclerosus. The signs and symptoms of this condition may include smooth, discolored skin patches in the affected area, blotchy, wrinkled skin patches, itching, burning feeling, easy bruising, fragile skin, changes in urine flow, bleeding, blistering or open sores, and painful sex. Lichen sclerosus occurs as a result of a combination of factors, such as an overactive immune system, genetic makeup, and previous skin damage or irritation.
Figure 01: Lichen Sclerosus
Lichen sclerosus can be diagnosed through physical examination and skin biopsy. Furthermore, treatment options for lichen sclerosus include using prescribed steroid ointment, clobetasol, calcineurin inhibitors like tacrolimus ointment, and procedures like circumcision.
What is Lichen Simplex Chronicus?
Lichen simplex chronicus, also called neurodermatitis, is a common type of eczema. It causes itchy and inflamed skin areas such as the head, neck, arms, scalp, and genitals. This condition could happen due to skin allergies, bug bites, very dry skin, skin conditions such as eczema or psoriasis, poor blood flow, tight or irritating clothing, sweat, stress, and anxiety. Some of the most common signs and symptoms of this condition are intense skin itching, pain, open sores, and bleeding.
Figure 02: Lichen Simplex Chronicus
Lichen simplex chronicus can be diagnosed through medical history, physical examination, patch testing, fungal culture, biopsy, and blood test. Furthermore, treatments for lichen simplex chronicus include using corticosteroids to reduce inflammation, calcineurin inhibitors, and antihistamines to reduce itchiness, antibiotics to reduce infections, anti-anxiety medications, coal tar preparations for dead skin removal, and capsaicin creams or patches that help relieve pain and itching.
Similarities Between Lichen Sclerosus and Lichen Simplex Chronicus
- Lichen sclerosus and lichen simplex chronicus are two skin conditions.
- Both can cause skin irritations and patches.
- They mainly affect females.
- Both can be seen in genital areas.
- Both can be diagnosed through physical examination and biopsy.
- They can be treated through topical and oral medications.
Difference Between Lichen Sclerosus and Lichen Simplex Chronicus
Definition
- Lichen sclerosus is a chronic inflammatory skin condition that causes itchy, white patches on the genitals or anal area.
- Lichen simplex chronicus is a chronic inflammatory skin condition that causes erythematous patches and plaques of thickened leathery skin on the head, neck, arms, scalp, and genitals.
Causes
- Lichen sclerosus can be caused by an overactive immune system, genetic makeup, allergies, and previous skin damage or irritation.
- Lichen simplex chronicus can be caused by insect bites, scars, eczema, dry skin, poor circulation in the leg, anxiety, and stress.
Signs and Symptoms
- Signs and symptoms of lichen sclerosus are ulcers and sores, inflammation, scarring cracking, pain while urinating, pain while having sex, weak urine stream, urine that may spray instead of coming out in a stream, tightening of the skin, inability to pull the foreskin back, and penile discharge.
- Signs and symptoms of lichen simplex chronicus are pruritic, dry, scaling, hyperpigmented, lichenified plaques in the shape of irregular, oval, or angular in the legs, arms, neck, upper trunk, and genital region, and excessive scratching.
Diagnosis
- Lichen sclerosus can be diagnosed through physical examination and skin biopsy.
- Lichen simplex chronicus can be diagnosed through medical history, clinical evaluation, patch testing, fungal culture, biopsy, and blood test.
Treatment
- Lichen sclerosus treatments include using topical corticosteroid creams, immunosuppressants, phototherapy, and surgeries like circumcision and urethroplasty.
- Lichen simplex chronicus treatments include prescription corticosteroid creams or ointments, prescription oral antihistamines, injection of corticosteroid solution directly into the lichen simplex chronicus lesions, ultraviolet light therapy, behavioral therapy, taking oral doxepin for anxiety, topical or oral antibiotics for infection.
The following table summarizes the difference between lichen sclerosus and lichen simplex chronicus.
Summary – Lichen Sclerosus vs Lichen Simplex Chronicus
Lichen sclerosus and lichen simplex chronicus share many similarities. Both cause itching and lichenification or thickening of the skin. It is possible to have just lichen sclerosus, just lichen simplex chronicus, or both these conditions. However, lichen sclerosus is an autoimmune condition, and lichen simplex chronicus is not. Moreover, lichen sclerosus causes itchy white patches on the genitals or anal area, while lichen simplex chronicus causes erythematous patches and plaques of thickened leathery skin on areas like the head, neck, arms, scalp, and genitals. In addition to that, lichen sclerosus must be treated for a lifetime, whereas most patients with lichen simplex chronicus can stop their medication once their skin has healed, usually within 6-8 weeks. This is the summary of the difference between lichen sclerosus and lichen simplex chronicus.
FAQ: Lichen Sclerosus and Lichen Simplex Chronicus
1. What is the main cause of lichen sclerosus?
- The exact cause of lichen sclerosus is unknown. However, research has found links to immune-related factors, genetic, environmental, hormonal, allergies, and previous skin damage or irritation.
2. What is the best treatment for lichen sclerosus?
- The best treatment methods for lichen sclerosus include using topical steroids such as clobetasol propionate, immunosuppressants, and phototherapy and recommended surgeries like circumcision and urethroplasty.
3. What does early lichen sclerosus look like?
- The primary symptoms of lichen sclerosus may include white, raised spots on areas like the vulva, anus, foreskin, or the tip of the penis, itching, soreness, discomfort, or burning feeling.
4. What causes lichen simplex chronicus?
- Lichen simplex chronicus (LSC) is a skin condition caused by chronic itching and scratching triggered by insect bites, scars, eczema, dry skin, poor circulation in the leg, anxiety, and stress.
5. What is the new treatment for lichen simplex chronicus?
- Transcutaneous electrical nerve stimulation (TENS) has been reported as a possible effective new treatment for cases of lichen simplex chronicus resistant to topical corticosteroid treatment. It is a method of pain relief involving the use of a mild electrical current.
Reference:
1. “Lichen Sclerosus.” Cleveland Clinic.
2. Charifa, Ahmad. “Lichen Simplex Chronicus.” StatPearls., U.S. National Library of Medicine.
Image Courtesy:
1. “Lichen sclerosus – intermed mag” By Nephron – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Lichen simplex chronicus 3” By kilbad (talk) – created this work entirely by myself. (CC BY 3.0) via Commons Wikimedia
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