Successful treatment of a rare case of widespread extragenital lichen sclerosus with narrow band UVB phototherapy

Fernanda Freitas De Brito,Ana Paula Cota Pinto Coelho,Adauto José Ferreira Nunes,Tatiana Cristina Pedro Cordeiro De Andrade,Claudio Sampieri Tonello,Ana Cecília Versiani Duarte Pinto

doi:10.5935/scd1984-8773.2015731668

Abstract

Lichen sclerosus is an uncommon condition affecting both the genital and extragenital region, the latter constituting an atypical occurrence of the disorder. The use of topical corticosteroids is considered the first-line treatment of this genital disease. Extragenital lesions are less sensitive to this therapy. The present study describes a case of lichen sclerosus in an 82-year-old female patient, with widespread extragenital involvement and successful treatment with narrow band UVB phototherapy. Lichen sclerosus is a chronic inflammatory dermatosis and disseminated forms of the condition are rare, with an absence of consensus on the treatment of the extragenital form. The choice for narrow band UVB therapy was based on the literature.

Highlights

Case ReportsAuthors: Fernanda Freitas de Brito[1] Tatiana Cristina Pedro Cordeiro de Andrade[2] Ana Paula Cota Pinto Coelho[3] Ana Cecília Versiani Duarte Pinto[1] Adauto José Ferreira Nunes[4] Claudio Sampieri Tonello[4]
Lichen sclerosus (LS) is an uncommon condition with a 0.1-0.3% prevalence, mainly affecting prepubescent and postmenopausal women.[1,2,3] It affects both the genital and extragenital region, the latter being an atypical presentation of the disorder.[3,4,5,6] In men, it primarily affects the glans and can be the cause of phimosis.[1, 3] The etiology is unknown, though evidence suggests that immunological mechanisms are involved in its pathogenesis due to association with other autoimmune diseases such as pernicious anemia, vitiligo, morphea, and autoimmune thyroiditis
LS is a chronic inflammatory, uncommon dermatosis,[1] first described in 1887 by Hallopeau.[1]. It is characterized by pearly-white plaques, which can be arranged in groups and progressively assume the aspect of parchment skin

Summary

Case Reports

Authors: Fernanda Freitas de Brito[1] Tatiana Cristina Pedro Cordeiro de Andrade[2] Ana Paula Cota Pinto Coelho[3] Ana Cecília Versiani Duarte Pinto[1] Adauto José Ferreira Nunes[4] Claudio Sampieri Tonello[4]. RESUMO O líquen escleroso é patologia incomum acometendo tanto região genital quanto extragenital, constituindo apresentação atípica da doença. Relata-se caso de líquen escleroso em paciente do sexo feminino, de 82 anos, com envolvimento extragenital generalizado e tratamento bem-sucedido com fototerapia UVB de banda estreita. O líquen escleroso é dermatose inflamatória crônica, e as formas disseminadas da doença são raras e sem consenso em relação ao tratamento da forma extragenital. This study was carried out at Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.

INTRODUCTION

Findings

DISCUSSION