title: [Plastic surgery as a last resort in lichen sclerosus].
abstract: Lichen sclerosus, formerly called lichen sclerosus et atrophicus, is a chronic skin disease manifesting itself mostly in the perineal region and often associated with itching. Characteristic elements are well-defined depigmentation and degeneration of the skin sometimes showing haemorrhagic bullae or teleangiectases. The skin grows thinner and shrinks. Malignant degeneration is rare. The prevalence is 1:300 to 1:1000. The condition occurs more often in females than in males and more often in adults than in children. Drug treatment (symptomatic) comprises local application of corticosteroids, anaesthetics and/or sex hormones. In case of insufficient response, cryotherapy is a good alternative. Chemical and surgical neurotomy are also sometimes applied, with fairly poor results. In refractory symptoms, excision of the affected skin, possibly with transplantation using a pedicled skin flap, may lead to mitigation.
authors.affiliation: Afd. Plastische Chirurgie, Academisch Ziekenhuis Vrije Universiteit, Amsterdam.
authors.forename: W R
authors.initials: WR
authors.lastname: van Straalen
authors.forename: J J
authors.initials: JJ
authors.lastname: Hage
authors.forename: E
authors.initials: E
authors.lastname: Bloemena
authors.forename: A
authors.initials: A
authors.lastname: Glastra
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000777:Anesthetics / Q000627:therapeutic use; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery; D005832:Genital Diseases, Male / Q000601:surgery; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000209:etiology; D013518:Surgery, Plastic / Q000379:methods*; D013684:Telangiectasis / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D000777:Anesthetics; D012739:Gonadal Steroid Hormones