Vulvar Lichen Sclerosus: It’s Not Just Itching

Vulvar Lichen Sclerosus: It’s Not Just Itching

Let’s talk about symptoms of vulvar lichen sclerosus.
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Changes in vulvar appearance- loss or resorption of the labia minora, covering of the clitoris with the clitoral hood (clitoral phimosis), narrowing of the vaginal opening.
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Fissures- small cuts, especially on the clitoral hood, between the labia minora and majora, and at the base of the vaginal opening (often with intercourse).
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Tightening or Discomfort- feeling of the vulvar skin being stretched or tight leading to discomfort.
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Itching- may not be present if estrogen levels are normal (premenopausal women).
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Pain with Sex- narrowing of the vaginal opening can occur leading to pain with insertion, there can be tearing at the top or bottom of the vaginal opening.
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Loss of Skin Pigment- white patches on the vulva, called hypopigmentation. Of note, chronic inflammation of LS can also lead to darkened areas, called hyperpigmentation.
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