Peristomal lichen sclerosus: the role of occlusion and urine exposure?
1Guy's and St Thomas' Hospital, St John's Institute of Dermatology, London, UK. firas55@hotmail.com
Background:
Lichen sclerosus (LS) is a chronic inflammatory skin disorder that typically affects the anogenital area. It presents with ivory-white atrophic patches or plaques with associated telangiectasia and occasional purpura. It has rarely been described as affecting abdominal stomas.
Objectives:
To investigate possible aetiological factors responsible for the development of this condition.
Methods:
All patients with peristomal LS were identified at a specialist stoma dermatology clinic and studied using a standardized pro forma.
Results:
We identified 12 patients with peristomal LS. The mean age was 72·3 years (range 47-85 years). With the exception of one patient, all our other patients had urostomies. Treatment was effective in the majority of cases.
Conclusions:
Peristomal LS, in our experience, is most commonly found around urostomies, and we speculate that in addition to the possible role of local trauma and occlusion, certain - as yet unidentified - constituents in the urine possibly play a role in its aetiology. It tends to respond well to corticosteroids and has not been associated with malignant transformation.
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