I have recently had the experience of talking to a fellow Nurse about a condition that I for one knew nothing about; Lichen Sclerosus. What was really interesting is that it’s a condition that women may have, but fail to have investigated for a myriad of reasons including embarrassment, the thought that they may have ‘thrush’ or even concern they may have contracted an STI. Failure to have proper investigations and management can increase a females’ risk of Vulval Cancer.
Here’s some information from the ‘caredownunder’ site which is focused on womens’ health. Note that Lichen Sclerosus can also occur in males and children.
‘ Although Lichen Sclerosus occurs in all age groups, it most often starts around menopause, typically in the 50’s. It can occur in children and in babies. It is much rarer in children than adults but it looks exactly the same. It can start at any age but most commonly around age five.Children with Lichen Sclerosus are itchy and sore, like adults, but they also commonly get constipated or have symptoms like a bladder infection. As a result, they often get referred to paediatricians rather than skin specialists.
If Lichen Sclerosus is left untreated in children, they may also develop scarring and loss of the structure of their vulva, just like an adult.
Lichen Sclerosus (LS) is an uncommon skin disease that usually occurs on the skin of the vulva and around the anus. Although LS can occur on any part of the skin, it is almost always a genital condition.LS can also be found on any part of the skin but is most common on the neck, buttocks, inner thigh, shoulders and wrists. It usually looks like a white patch but can also look like multiple small white spots.
The true reason for LS remains unknown, however we know that some patients with it may also have what is called “auto-immune disease”. The commonest of these diseases seen with LS are thyroid disease and vitiligo, a condition where colour is lost from the skin.
LS can run in families. Mothers and daughters as well as sisters can be affected. So if you have LS, you should tell your relatives.
Lichen Sclerosus doesn’t always cause symptoms and can be picked up by chance because you happened to have a look for some other reason, or was discovered by your GP when you had a Pap test. However, it is usually intensely itchy, and sometimes painful as a result of scratching and splitting. It may look white, sometimes with purple flecks or blisters. Many women also notice that their vulva, clitoris and vaginal opening seems to be getting smaller.
Patients with LS are at risk for vulval cancer. Diagnosis is based on clinical presentation and often a biopsy of the tissue in the affected area. Potent topical cortisone cream is the best treatment for LS and is a life long maintenance treatment.
The point of raising this topic is to remind us all, that despite Nurses being very familiar with the body’s anatomy, when it comes to ourselves, its a whole different ballgame with Nurses demonstrating the same level of reticence and hesitation as the general population re seeing a Doctor about a concern of a personal nature.
We tell our patients to remain aware of changes in their bodies and to seek advice when unsure. As Nurses we need to remember to adopt the same advice and seek a review when unsure, rather than doing the ‘she’ll be right mate’ or self-diagnosis via Dr Google. Take care of yourself – if you don’t who will?
You can read more about Lichen Sclerosus here>>
The Nurses for Nurses Network provides good information and CPD on an array of nursing topics in a range of easy learning ways including webinars and quizzes on the latest information that Nurses need to know – remember the Nurses for Nurses Network was created by Australian Nurses for Nurses! www.nursesfornurses.com.au