Abstract
The review analyses data on possible causes of lichen sclerosis development, lists the histologic reports on changes in skin and urethra in genital lichen sclerosis with urethra strictures. The description of immunological barriers of urethra and the role of cell and humoral immunity disruption in development of pathological protein and extracellular matrix of connective tissue is provided. The review also lists the role of fibroblasts and fibroblast-mediated factors of inflammation in disruption of connective tissue and outlines the changes of extracellular matrix during immune response along with the influence of matrix metalloproteinases and their inhibitors. The data on regulating role of sex hormones, role of folate cycle disorders and related increase of homocysteine blood levels on the protein structure and extracellular marix of skin and urethra connective tissue is provided. A role of androgen deficiency in development of lichen sclerosis is listed. Finally the review describes the natural course of lichen sclerosis development and lists the methods of substitutive urethroplasties along with the materials used for urethra stricture treatment.
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