[Plastic surgery as a last resort in lichen sclerosus]

Lichen sclerosus, formerly called lichen sclerosus et atrophicus, is a chronic skin disease manifesting itself mostly in the perineal region and often associated with itching. Characteristic elements are well-defined depigmentation and degeneration of the skin sometimes showing haemorrhagic bullae or teleangiectases. The skin grows thinner and shrinks. Malignant degeneration is rare. The prevalence is 1:300 to 1:1000. The condition occurs more often in females than in males and more often in adults than in children. Drug treatment (symptomatic) comprises local application of corticosteroids, anaesthetics and/or sex hormones. In case of insufficient response, cryotherapy is a good alternative. Chemical and surgical neurotomy are also sometimes applied, with fairly poor results. In refractory symptoms, excision of the affected skin, possibly with transplantation using a pedicled skin flap, may lead to mitigation.