lichen sclerosus vs lichen planus

[Guest Posts]

I was wondering what the differences were between lichen sclerosus vs lichen planus. I was diagnosed late last year and had suffered with symptoms for about 2 years. I’m not sure which I have because two doctors told me two different things. A third doctor told me it could be either or and didn’t want to do a biopsy. The itching some days is so unbearable. Any tips would be greatly appreciated.

Best,

Angelica

[Dr Nevianna Bordet]

This question has already been posted on this forum and my reply was : Although lichen planus (LP) and lichen sclerosus (LS) are different conditions, I have seen patients in the Vulval clinic where there seems to be an overlap between the conditions. Lichen planus can affect the vagina internally as well as the outer vulval part of the skin. LP can also affect the mouth or gums, usually with sore areas. On the skin it is usually very itchy whereas in the genital area it is usually painful, although it can also be itchy. The scalp can also be affected by LP and can even lead to scarring hair loss.
LS on the other hand usually only affects the genitals. It does not affect the vagina internally and typically causes itching, although if severe it can lead to pain. It can affect the skin, but much more rarely than LP and usually on the skin it is not very itchy (unlike LP which is one of the most itchy skin conditions).
In your case, if your specialist feels you may have either LS or LP, you may have an overlap between the two conditions. Vulval LP and LS are treated in the same way, with potent steroid creams or ointments, so a biopsy is not always necessary.