The three lichens: sclerosus, planus and erosive

Lichen sclerosus (LS) and lichen planus (LP) are diseases of an inflammatory nature that attack the skin and anogenital region, and sometimes they might have a difficult clinical differentiation in their early stages. LE has its incidence demonstrated in 1.7% of gynecological consultations in all age groups. LP attacks about 1% of women, but its true incidence is difficult to assess. LE and LP are diseases whose pathogenesis is multifactorial. Genetic and hormonal factors, infections and trauma were associated with the development of LE, while LP has its development less understood; however, it is also associated with genetic factors, infections and the use of certain medications. Both diseases cause much discomfort to the patient, because they may present with pain, burning, itching and there is also the possibility of stenosis of the vaginal opening and consequent dyspareunia. On suspicion of LE and LP should be done differential diagnosis with other skin diseases and vaginal intraepithelial neoplasia (VIN). The risk of malignant transformation justifies the monitoring that patients should have in the rest of their life. The first-line treatment for LE and LP consists of topical corticosteroids super powerful. The diagnosis often requires biopsy for confirmation. The aim of this study was to review the pathophysiology, complications and treatment of these diseases, which are very important because they have no cure and can seriously compromise the quality of life of patients.(AU)