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What Causes Discolored Spots On The Scalp, Nose, Face, Chest, Arm And Back?
Question: I have been experiencing spots (discoloration) on my scalp, nose, face, chest, arm, stomach and back; these spots do not itch but keep spreading. I have tried several medications (tablets and creams: Nizoral Shampoo, Ketonazole Cream, Griseofulvin Tablets, Itraconazole 100mg Capsule) but no improvement. Finally decided to have a skin biopsy and the investigation/result shows Lichen Sclerosus. What's the meaning, cause and treatment options/medications? Thanks,
Brief Answer:
Chronic disease, cause unknown, no permanent treatment available
Detailed Answer:
Hi
Thanks for being at healthcaremagic
I am Dr Asmeet Kaur Sawhney, a dermatologist.
I have gone through your complaints and lichen sclerosus is a chronic connective tissue disease of the skin characterised by white areas at any site of the body but mostly in the penile skin and foreskin in males and perineal skin in female.
The cause of this disease is unknown at present.
The disease occurs spontaneously in some individuals.
In some persons role of hormonal factors, autoimmune diseases, trauma and chronic balanitis have been related to the occurence of lichen sclerosus.
The disease is usually permanent and occasionally resolves spontaneously.
The signs and symptoms show relapses and remissions.
There are no confirmed effective treatments for this disorder although potent topical steroids, calcipotriol and topical tacrolimus and pimecrolimus have beed found effective in some persons.
Even phototherapy and oral mycophenolate mofetil has been found useful .
I hope this information is of help to you.
Regards
Dr Asmeet
Chronic disease, cause unknown, no permanent treatment available
Detailed Answer:
Hi
Thanks for being at healthcaremagic
I am Dr Asmeet Kaur Sawhney, a dermatologist.
I have gone through your complaints and lichen sclerosus is a chronic connective tissue disease of the skin characterised by white areas at any site of the body but mostly in the penile skin and foreskin in males and perineal skin in female.
The cause of this disease is unknown at present.
The disease occurs spontaneously in some individuals.
In some persons role of hormonal factors, autoimmune diseases, trauma and chronic balanitis have been related to the occurence of lichen sclerosus.
The disease is usually permanent and occasionally resolves spontaneously.
The signs and symptoms show relapses and remissions.
There are no confirmed effective treatments for this disorder although potent topical steroids, calcipotriol and topical tacrolimus and pimecrolimus have beed found effective in some persons.
Even phototherapy and oral mycophenolate mofetil has been found useful .
I hope this information is of help to you.
Regards
Dr Asmeet
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Many thanks Doctor Asmeet.
My concern is that this pigmentation do not occur on my penile skin at all but rather on my face, nose, scalp, chest, arm, back and stomach. What more can you say about this?
What OTC (Over the Counter) drugs, creams and ointments would you prescribe? Is there any other laboratory tests/clinical investigation to be carried out?
Regards,
My concern is that this pigmentation do not occur on my penile skin at all but rather on my face, nose, scalp, chest, arm, back and stomach. What more can you say about this?
What OTC (Over the Counter) drugs, creams and ointments would you prescribe? Is there any other laboratory tests/clinical investigation to be carried out?
Regards,
Brief Answer:
Biopsy is confirmatory, only emollients & cortisone can be used as OTC
Detailed Answer:
Lichen sclerosus frequently involves anogenital area in 85-95 percent of cases and extragenital sites are involved in only 15-20 percent of the individuals.
You have developed the less common extragenital lichen sclerosus.
Diseases like vitiligo, thyroid disorders, pernicious anemia and alopecia areata are most commonly associated disorders with lichen sclerosus.
Biopsy is confirmatory for the diagnosis.
No further laboratory investigations are required.
Only emmolients and cortisone cream can be used as over the counter medicines.
All the other treatment options fall in prescription category and you need to take treatment under the supervision of the dermatologist.
Biopsy is confirmatory, only emollients & cortisone can be used as OTC
Detailed Answer:
Lichen sclerosus frequently involves anogenital area in 85-95 percent of cases and extragenital sites are involved in only 15-20 percent of the individuals.
You have developed the less common extragenital lichen sclerosus.
Diseases like vitiligo, thyroid disorders, pernicious anemia and alopecia areata are most commonly associated disorders with lichen sclerosus.
Biopsy is confirmatory for the diagnosis.
No further laboratory investigations are required.
Only emmolients and cortisone cream can be used as over the counter medicines.
All the other treatment options fall in prescription category and you need to take treatment under the supervision of the dermatologist.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Dear Dr. Asmeer,
I also know that extragenital LS is typically asymptomatic. However, I am not comfortable with it at all. I wish you could feel my pulse!
Which therapy would you recommend; Which emmolients, cortisone cream and medicines (OTC) can be used or best suited?
Regards,
I also know that extragenital LS is typically asymptomatic. However, I am not comfortable with it at all. I wish you could feel my pulse!
Which therapy would you recommend; Which emmolients, cortisone cream and medicines (OTC) can be used or best suited?
Regards,
Brief Answer:
Unfortunately medicines won't be available as OTC
Detailed Answer:
Unfortunately there are no OTC medicines which will be effective in lichen sclerosus.
I can understand your condition but I am helpless as medicines won't be available as OTC.
Potent topical steroids or tacrolimus ointment or calcipotriol ointment can be effective but you can't get them over the counter.
At the most you can simply try using a lotion containing white soft paraffin on the entire body twice daily and hydrocortisone cream on the affected white spots twice daily but hydrocortisone is a very mild steroid which won't have any significant benefit in your case.
Unfortunately medicines won't be available as OTC
Detailed Answer:
Unfortunately there are no OTC medicines which will be effective in lichen sclerosus.
I can understand your condition but I am helpless as medicines won't be available as OTC.
Potent topical steroids or tacrolimus ointment or calcipotriol ointment can be effective but you can't get them over the counter.
At the most you can simply try using a lotion containing white soft paraffin on the entire body twice daily and hydrocortisone cream on the affected white spots twice daily but hydrocortisone is a very mild steroid which won't have any significant benefit in your case.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
I would have loved to get the Tacrolimus or calcipotriol ointment. How can I get this particular ointment or cream? Do you have a platform for buying and shipping? You said I can use a lotion containing white soft paraffin. Can you be more specific on the choice of paraffin?
Brief Answer:
No platform for buying or shipping of medicines
Detailed Answer:
No we don't have any platform for buying and shipping of medicines.
You need to get these medicines from the doctor.
White soft paraffin is the basic content of many moisturizers lile parasoft cream or venussia cream or moisturex soft cream or aquasoft cream.
You can buy either of the above,
All are equally good.
No platform for buying or shipping of medicines
Detailed Answer:
No we don't have any platform for buying and shipping of medicines.
You need to get these medicines from the doctor.
White soft paraffin is the basic content of many moisturizers lile parasoft cream or venussia cream or moisturex soft cream or aquasoft cream.
You can buy either of the above,
All are equally good.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
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