Lichen sclerosus (LS) is an uncommon condition that creates patchy, white skin that's thinner than normal. Lichen sclerosus can affect skin anywhere on your body. But it most often involves skin of the vulva, foreskin of the penis or skin around the anus. Inflammation and altered fibroblast function in the papillary dermis leads to fibrosis of the upper dermis. Genital skin and mucosa are affected most frequently, but extragenital lichen sclerosus does occur, and even rare oral presentations are reported. The role that hypoxia and ischemia have in the initial cellular and vascular damage is supported by the finding of increased glut-1 and decreased vascular endothelial growth factor (VEGF) expression in affected skin.
Research studies have indicated that 44% to 74% of women with LS have tested positive for circulating immunoglobulin autoantibodies. High rates of VLS among first-degree relatives supports the theory that a genetic component exists in this condition. Up to 12% of patients with VLS have a positive family history of the disease.