title: Lichen sclerosus in a breast cancer survivor on an aromatase inhibitor: a case report.
abstract: Lichen sclerosus is a commonly misdiagnosed disease that is characterized by thinned, hypopigmented, crinkled skin that often forms a figure-eight shape around the vaginal and anal openings. We present a case of advanced lichen sclerosus in a 53-year-old female patient prescribed a nonsteroidal aromatase inhibitor after the excision of a breast cancer tumor. We present a diagnostic approach to lichen sclerosus by recognizing its common figure-eight pattern, and we review the known causes and treatment of lichen sclerosus. Research has shown that lichen sclerosus is more common in low estrogen states, and thus it is logical that aromatase inhibitors could increase a patient's risk for developing this disease. We therefore propose that all patients prescribed aromatase inhibitors undergo regular vulvo-vaginal exams to rule out lichen sclerosus and other hypoestrogen-related vulvo-vaginal problems.
authors.affiliation: Division of General Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Women's Health Team, Fenway Health, Boston, MA, USA. jpotter@bidmc.harvard.edu
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Potter
authors.forename: Kendra A
authors.initials: KA
authors.lastname: Moore
mesh_terms: D000077384:Anastrozole; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D002990:Clobetasol / Q000627:therapeutic use; D003875:Drug Eruptions / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009570:Nitriles / Q000009:adverse effects* / Q000627:therapeutic use; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use; D007724:Vulvar Lichen Sclerosus / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D005938:Glucocorticoids; D009570:Nitriles; D014230:Triazoles; D000077384:Anastrozole; D002990:Clobetasol