Lichen sclerosus - Revision history

Michael: /* Sign out */

2021-09-30T17:56:24Z

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			<pre>
			Foreskin, Circumcision:
			- Lichen sclerosus.
			- NEGATIVE for malignancy.
			</pre>

			===Block letters===
	<pre>		<pre>
	VULVA, BIOPSY:		VULVA, BIOPSY:

Alessandro: typos

2019-03-04T14:55:33Z

typos

← Older revision		Revision as of 14:55, 4 March 2019
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	\| Clinicalhx =		\| Clinicalhx =
	\| Signs =		\| Signs =
	\| Symptoms = ~~pruritis~~		\| Symptoms = pruritus
	\| Prevalence =		\| Prevalence =
	\| Bloodwork =		\| Bloodwork =
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	Clinical:		Clinical:
	*~~Pruritis~~ -> leads to scratching.		*Pruritus -> leads to scratching.
	*Chronic condition.		*Chronic condition.
	*Usu. post-menopausal women.		*Usu. post-menopausal women.
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	===Micro===		===Micro===
	====~~Inflammtory~~ phase of lichen sclerosus====		====Inflammatory phase of lichen sclerosus====
	The sections show skin with a lymphoplasmacytic predominant interface dermatitis with hyperkeratosis. Spongiosis is present. Scattered inflammatory cell are found with the basal aspect of the epidermis; however, they do not form clusters. No mitotic activity is appreciated.		The sections show skin with a lymphoplasmacytic predominant interface dermatitis with hyperkeratosis. Spongiosis is present. Scattered inflammatory cell are found with the basal aspect of the epidermis; however, they do not form clusters. No mitotic activity is appreciated.

Michael at 18:05, 12 April 2016

2016-04-12T18:05:26Z

← Older revision		Revision as of 18:05, 12 April 2016
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	\| Gross =		\| Gross =
	\| Grossing =		\| Grossing =
	\| Site = [[vulva]], [[penis]]		\| Site = [[vulva]], [[penis]], [[urethra]]
	\| Assdx = [[differentiated vulvar intraepithelial neoplasia]], [[vulvar squamous cell carcinoma]]		\| Assdx = [[differentiated vulvar intraepithelial neoplasia]], [[vulvar squamous cell carcinoma]]
	\| Syndromes =		\| Syndromes =

Michael at 18:03, 12 April 2016

2016-04-12T18:03:13Z

← Older revision		Revision as of 18:03, 12 April 2016
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	\| Width =		\| Width =
	\| Caption = Lichen sclerosus. [[H&E stain]].		\| Caption = Lichen sclerosus. [[H&E stain]].
			\| Synonyms = balanitis xerotica obliterans (old term for lesion on glans penis)
	\| Micro = fibrosis of dermis with loss of adnexal structures - '''key feature''', loss of the rete ridges, (severe) [[hyperkeratosis]], inflammation - often with eosinophils		\| Micro = fibrosis of dermis with loss of adnexal structures - '''key feature''', loss of the rete ridges, (severe) [[hyperkeratosis]], inflammation - often with eosinophils
	\| Subtypes =		\| Subtypes =
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	'''Lichen sclerosus''' is a relatively common chronic condition classically associated with the [[vulva]]. On the vulva is also known as ''chronic atrophic vulvitis''.		'''Lichen sclerosus''' is a relatively common chronic condition classically associated with the [[vulva]]. On the vulva is also known as ''chronic atrophic vulvitis''.

	On the ~~glands~~ [[penis]] it is referred to as '''balanitis xerotica obliterans''', abbreviated '''BXO'''.<ref name=pmid12602704>{{cite journal \|author=Finkbeiner AE \|title=Balanitis xerotica obliterans: a form of lichen sclerosus \|journal=South. Med. J. \|volume=96 \|issue=1 \|pages=7–8 \|year=2003 \|month=January \|pmid=12602704 \|doi= \|url=}}</ref>		On the glans [[penis]] it was referred to as '''balanitis xerotica obliterans''', abbreviated '''BXO'''.<ref name=pmid12602704>{{cite journal \|author=Finkbeiner AE \|title=Balanitis xerotica obliterans: a form of lichen sclerosus \|journal=South. Med. J. \|volume=96 \|issue=1 \|pages=7–8 \|year=2003 \|month=January \|pmid=12602704 \|doi= \|url=}}</ref><ref name=pmid24268357>{{Cite journal \| last1 = Stewart \| first1 = L. \| last2 = McCammon \| first2 = K. \| last3 = Metro \| first3 = M. \| last4 = Virasoro \| first4 = R. \| title = SIU/ICUD Consultation on Urethral Strictures: Anterior urethra-lichen sclerosus. \| journal = Urology \| volume = 83 \| issue = 3 Suppl \| pages = S27-30 \| month = Mar \| year = 2014 \| doi = 10.1016/j.urology.2013.09.013 \| PMID = 24268357 }}</ref>

	==General==		==General==

Sarah: /* Sign out */

2014-10-29T11:37:54Z

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	Note:		Note:
	*''BXO'' afflicts the ~~glands~~.		*''BXO'' afflicts the glans penis.

	===Micro===		===Micro===

Michael: /* Microscopic */

2014-10-28T16:25:43Z

Microscopic

← Older revision		Revision as of 16:25, 28 October 2014
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	*Lichenoid inflammatory infiltrate - often with eosinophils; may destroy the dermal-epidermal junction leading to blister formation.		*Lichenoid inflammatory infiltrate - often with eosinophils; may destroy the dermal-epidermal junction leading to blister formation.
	**May be prominent - in the ''inflammatory phase'' of the disease.<ref name=pmid9537476>{{Cite journal \| last1 = Fung \| first1 = MA. \| last2 = LeBoit \| first2 = PE. \| title = Light microscopic criteria for the diagnosis of early vulvar lichen sclerosus: a comparison with lichen planus. \| journal = Am J Surg Pathol \| volume = 22 \| issue = 4 \| pages = 473-8 \| month = Apr \| year = 1998 \| doi = \| PMID = 9537476 }}</ref>		**May be prominent - in the ''inflammatory phase'' of the disease.<ref name=pmid9537476>{{Cite journal \| last1 = Fung \| first1 = MA. \| last2 = LeBoit \| first2 = PE. \| title = Light microscopic criteria for the diagnosis of early vulvar lichen sclerosus: a comparison with lichen planus. \| journal = Am J Surg Pathol \| volume = 22 \| issue = 4 \| pages = 473-8 \| month = Apr \| year = 1998 \| doi = \| PMID = 9537476 }}</ref>

			Notes:
			*May have [[angiokeratoma]]-like changes.<ref name=pmid19187108>{{Cite journal \| last1 = Luzar \| first1 = B. \| last2 = Neil \| first2 = SM. \| last3 = Calonje \| first3 = E. \| title = Angiokeratoma-like changes in extragenital and genital lichen sclerosus. \| journal = J Cutan Pathol \| volume = 36 \| issue = 5 \| pages = 540-2 \| month = May \| year = 2009 \| doi = 10.1111/j.1600-0560.2008.01091.x \| PMID = 19187108 }}</ref>

	DDx:		DDx:

Sarah: /* Microscopic */

2014-09-15T06:41:55Z

Microscopic

← Older revision		Revision as of 06:41, 15 September 2014
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	*Severe [[hyperkeratosis]].		*Severe [[hyperkeratosis]].
	**Hyperkeratosis = stratum corneum thickened.		**Hyperkeratosis = stratum corneum thickened.
	*Fibrosis of dermis with loss of adnexal structures - '''key feature'''.		*Fibrosis of the superficial dermis with loss of adnexal structures - '''key feature'''.
	**~~May appear~~ pale ~~- directly deep to the epidermis~~.<ref>URL: [http://www.webpathology.com/image.asp?n=2&Case=538 http://www.webpathology.com/image.asp?n=2&Case=538]. Accessed on: 25 August 2011.</ref>		**Superficial dermis appears pale and homogeneous (distinct collagen bundles are lost).<ref>URL: [http://www.webpathology.com/image.asp?n=2&Case=538 http://www.webpathology.com/image.asp?n=2&Case=538]. Accessed on: 25 August 2011.</ref>
	*~~Inflammation~~ - often with eosinophils.		*Lichenoid inflammatory infiltrate - often with eosinophils; may destroy the dermal-epidermal junction leading to blister formation.
	**May be prominent - in the ''inflammatory phase'' of the disease.<ref name=pmid9537476>{{Cite journal \| last1 = Fung \| first1 = MA. \| last2 = LeBoit \| first2 = PE. \| title = Light microscopic criteria for the diagnosis of early vulvar lichen sclerosus: a comparison with lichen planus. \| journal = Am J Surg Pathol \| volume = 22 \| issue = 4 \| pages = 473-8 \| month = Apr \| year = 1998 \| doi = \| PMID = 9537476 }}</ref>		**May be prominent - in the ''inflammatory phase'' of the disease.<ref name=pmid9537476>{{Cite journal \| last1 = Fung \| first1 = MA. \| last2 = LeBoit \| first2 = PE. \| title = Light microscopic criteria for the diagnosis of early vulvar lichen sclerosus: a comparison with lichen planus. \| journal = Am J Surg Pathol \| volume = 22 \| issue = 4 \| pages = 473-8 \| month = Apr \| year = 1998 \| doi = \| PMID = 9537476 }}</ref>

Sarah: /* Microscopic */

2014-09-15T06:31:01Z

Microscopic

← Older revision		Revision as of 06:31, 15 September 2014
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	*Cutaneous [[amyloidosis]] - classically has "cracked" appearance.		*Cutaneous [[amyloidosis]] - classically has "cracked" appearance.
	*[[Malignant melanoma]] with regression - esp. for the ''inflammatory phase of lichen sclerosus''.		*[[Malignant melanoma]] with regression - esp. for the ''inflammatory phase of lichen sclerosus''.
	*[[Mycosis fungoides]] - the inflammatory infiltrate of lichen sclerosis can closely mimic mycosis fungoides (which almost never presents in a genital area).<ref name=pmid14631186/>{{Cite journal \| last1 = Citarella \| first1 = L. \| last2 = Massone \| first2 = C. \| last3 = Kerl \| first3 = H. \| last4 = Cerroni \| first4 = L. \| title = Lichen sclerosus with histopathologic features simulating early mycosis fungoides. \| journal = Am J Dermatopathol \| volume = 25 \| issue = 6 \| pages = 463-5 \| month = Dec \| year = 2003 \| doi = \| PMID = 14631186 }}</ref>		*[[Mycosis fungoides]] - the inflammatory infiltrate of lichen sclerosis can closely mimic mycosis fungoides (which almost never presents in a genital area).<ref name=pmid14631186>{{Cite journal \| last1 = Citarella \| first1 = L. \| last2 = Massone \| first2 = C. \| last3 = Kerl \| first3 = H. \| last4 = Cerroni \| first4 = L. \| title = Lichen sclerosus with histopathologic features simulating early mycosis fungoides. \| journal = Am J Dermatopathol \| volume = 25 \| issue = 6 \| pages = 463-5 \| month = Dec \| year = 2003 \| doi = \| PMID = 14631186 }}</ref>

	====Images====		====Images====

Sarah: /* Microscopic */

2014-09-15T06:28:49Z

Microscopic

← Older revision		Revision as of 06:28, 15 September 2014
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	*Cutaneous [[amyloidosis]] - classically has "cracked" appearance.		*Cutaneous [[amyloidosis]] - classically has "cracked" appearance.
	*[[Malignant melanoma]] with regression - esp. for the ''inflammatory phase of lichen sclerosus''.		*[[Malignant melanoma]] with regression - esp. for the ''inflammatory phase of lichen sclerosus''.
	*[[Mycosis fungoides]] - the inflammatory infiltrate of lichen sclerosis can closely mimic mycosis fungoides (which almost never presents in a genital area).<ref name=pmid14631186/>		*[[Mycosis fungoides]] - the inflammatory infiltrate of lichen sclerosis can closely mimic mycosis fungoides (which almost never presents in a genital area).<ref name=pmid14631186/>{{Cite journal \| last1 = Citarella \| first1 = L. \| last2 = Massone \| first2 = C. \| last3 = Kerl \| first3 = H. \| last4 = Cerroni \| first4 = L. \| title = Lichen sclerosus with histopathologic features simulating early mycosis fungoides. \| journal = Am J Dermatopathol \| volume = 25 \| issue = 6 \| pages = 463-5 \| month = Dec \| year = 2003 \| doi = \| PMID = 14631186 }}</ref>

	====Images====		====Images====

Sarah: /* Microscopic */

2014-09-15T06:14:46Z

Microscopic

← Older revision		Revision as of 06:14, 15 September 2014
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	*Cutaneous [[amyloidosis]] - classically has "cracked" appearance.		*Cutaneous [[amyloidosis]] - classically has "cracked" appearance.
	*[[Malignant melanoma]] with regression - esp. for the ''inflammatory phase of lichen sclerosus''.		*[[Malignant melanoma]] with regression - esp. for the ''inflammatory phase of lichen sclerosus''.
			*[[Mycosis fungoides]] - the inflammatory infiltrate of lichen sclerosis can closely mimic mycosis fungoides (which almost never presents in a genital area).<ref name=pmid14631186/>

	====Images====		====Images====