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Nathan Lawrentschuk - One of the best experts on this subject based on the ideXlab platform.

  • Penile Lichen Sclerosus (balanitis xerotica obliterans)
    BJU International, 2011
    Co-Authors: David Clouston, Anthony Hall, Nathan Lawrentschuk
    Abstract:

    What's known on the subject? and What does the study add? The clinical presentation and complications of Lichen Sclerosus are well known. What is less well known is the true incidence of the condition. The published figures are all based on attendance at general medical clinics or specialist clinics, but it is likely that the true incidence is much higher than this reported incidence as many men will not present to the doctor for treatment. The other uncertainty is the relationship of Lichen Sclerosus to the subsequent development of cancer of the penis. As pointed out in the paper, it is likely that between 4% and 8% of men with this condition will develop squamous cell cancer of the penis. However, it is unclear if Lichen Sclerosus itself causes the development of squamous cell cancer or if it is due to coexistent infection with human papillomavirus. This review provides a concise summary of the clinical and pathological features of the disease and describes its current medical and surgical treatment. It brings together a number of papers which have addressed the association of Lichen Sclerosus with squamous cell carcinoma of the penis and shows that the likely incidence of carcinoma is approximately 4–8% in men with this condition. SUMMARY Penile Lichen Sclerosus, also known as balanitis xerotica obliterans, is a chronic inflammatory condition of the penis which can occur at all ages. The inflammation leads to the formation of white plaques most commonly on the foreskin or penis, and can lead to inability to retract the foreskin or blockage to the flow of urine. Cancer may occur rarely. Penile Lichen Sclerosus is a progressive, sclerosing, inflammatory dermatosis of the glans penis and foreskin which is of uncertain aetiology. Recent studies have shown a link between Lichen Sclerosus and squamous cell carcinoma of the penis. In this review, we discuss the clinical presentation, pathology and current approach to treatment of this condition.

  • Penile Lichen Sclerosus (balanitis xerotica obliterans).
    BJU international, 2011
    Co-Authors: David Clouston, Anthony Hall, Nathan Lawrentschuk
    Abstract:

    What's known on the subject? and What does the study add? The clinical presentation and complications of Lichen Sclerosus are well known. What is less well known is the true incidence of the condition. The published figures are all based on attendance at general medical clinics or specialist clinics, but it is likely that the true incidence is much higher than this reported incidence as many men will not present to the doctor for treatment. The other uncertainty is the relationship of Lichen Sclerosus to the subsequent development of cancer of the penis. As pointed out in the paper, it is likely that between 4% and 8% of men with this condition will develop squamous cell cancer of the penis. However, it is unclear if Lichen Sclerosus itself causes the development of squamous cell cancer or if it is due to coexistent infection with human papillomavirus. This review provides a concise summary of the clinical and pathological features of the disease and describes its current medical and surgical treatment. It brings together a number of papers which have addressed the association of Lichen Sclerosus with squamous cell carcinoma of the penis and shows that the likely incidence of carcinoma is approximately 4-8% in men with this condition. Penile Lichen Sclerosus, also known as balanitis xerotica obliterans, is a chronic inflammatory condition of the penis which can occur at all ages. The inflammation leads to the formation of white plaques most commonly on the foreskin or penis, and can lead to inability to retract the foreskin or blockage to the flow of urine. Cancer may occur rarely. Penile Lichen Sclerosus is a progressive, sclerosing, inflammatory dermatosis of the glans penis and foreskin which is of uncertain aetiology. Recent studies have shown a link between Lichen Sclerosus and squamous cell carcinoma of the penis. In this review, we discuss the clinical presentation, pathology and current approach to treatment of this condition. © 2011 THE AUTHOR. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

David Clouston - One of the best experts on this subject based on the ideXlab platform.

  • Penile Lichen Sclerosus (balanitis xerotica obliterans)
    BJU International, 2011
    Co-Authors: David Clouston, Anthony Hall, Nathan Lawrentschuk
    Abstract:

    What's known on the subject? and What does the study add? The clinical presentation and complications of Lichen Sclerosus are well known. What is less well known is the true incidence of the condition. The published figures are all based on attendance at general medical clinics or specialist clinics, but it is likely that the true incidence is much higher than this reported incidence as many men will not present to the doctor for treatment. The other uncertainty is the relationship of Lichen Sclerosus to the subsequent development of cancer of the penis. As pointed out in the paper, it is likely that between 4% and 8% of men with this condition will develop squamous cell cancer of the penis. However, it is unclear if Lichen Sclerosus itself causes the development of squamous cell cancer or if it is due to coexistent infection with human papillomavirus. This review provides a concise summary of the clinical and pathological features of the disease and describes its current medical and surgical treatment. It brings together a number of papers which have addressed the association of Lichen Sclerosus with squamous cell carcinoma of the penis and shows that the likely incidence of carcinoma is approximately 4–8% in men with this condition. SUMMARY Penile Lichen Sclerosus, also known as balanitis xerotica obliterans, is a chronic inflammatory condition of the penis which can occur at all ages. The inflammation leads to the formation of white plaques most commonly on the foreskin or penis, and can lead to inability to retract the foreskin or blockage to the flow of urine. Cancer may occur rarely. Penile Lichen Sclerosus is a progressive, sclerosing, inflammatory dermatosis of the glans penis and foreskin which is of uncertain aetiology. Recent studies have shown a link between Lichen Sclerosus and squamous cell carcinoma of the penis. In this review, we discuss the clinical presentation, pathology and current approach to treatment of this condition.

  • Penile Lichen Sclerosus (balanitis xerotica obliterans).
    BJU international, 2011
    Co-Authors: David Clouston, Anthony Hall, Nathan Lawrentschuk
    Abstract:

    What's known on the subject? and What does the study add? The clinical presentation and complications of Lichen Sclerosus are well known. What is less well known is the true incidence of the condition. The published figures are all based on attendance at general medical clinics or specialist clinics, but it is likely that the true incidence is much higher than this reported incidence as many men will not present to the doctor for treatment. The other uncertainty is the relationship of Lichen Sclerosus to the subsequent development of cancer of the penis. As pointed out in the paper, it is likely that between 4% and 8% of men with this condition will develop squamous cell cancer of the penis. However, it is unclear if Lichen Sclerosus itself causes the development of squamous cell cancer or if it is due to coexistent infection with human papillomavirus. This review provides a concise summary of the clinical and pathological features of the disease and describes its current medical and surgical treatment. It brings together a number of papers which have addressed the association of Lichen Sclerosus with squamous cell carcinoma of the penis and shows that the likely incidence of carcinoma is approximately 4-8% in men with this condition. Penile Lichen Sclerosus, also known as balanitis xerotica obliterans, is a chronic inflammatory condition of the penis which can occur at all ages. The inflammation leads to the formation of white plaques most commonly on the foreskin or penis, and can lead to inability to retract the foreskin or blockage to the flow of urine. Cancer may occur rarely. Penile Lichen Sclerosus is a progressive, sclerosing, inflammatory dermatosis of the glans penis and foreskin which is of uncertain aetiology. Recent studies have shown a link between Lichen Sclerosus and squamous cell carcinoma of the penis. In this review, we discuss the clinical presentation, pathology and current approach to treatment of this condition. © 2011 THE AUTHOR. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

Hope K. Haefner - One of the best experts on this subject based on the ideXlab platform.

  • Vulvar Lichen Sclerosus in the Elderly
    Drugs & Aging, 2009
    Co-Authors: Natalie A. Saunders, Hope K. Haefner
    Abstract:

    Lichen Sclerosus is a chronic skin condition that most commonly affects the anogenital skin of postmenopausal women. The aetiology of the condition is multifactorial. The most common presenting symptom is itching. Lichen Sclerosus has a characteristic appearance. Diagnosis is made with vulvar biopsy. Treatment is important and the regimen most often includes topical corticosteroid ointments. Lifetime surveillance of the skin is imperative because of the increased risk of squamous cell carcinoma in patients with Lichen Sclerosus.

  • Vulvar Lichen Sclerosus in the elderly: pathophysiology and treatment update.
    Drugs & aging, 2009
    Co-Authors: Natalie A. Saunders, Hope K. Haefner
    Abstract:

    Lichen Sclerosus is a chronic skin condition that most commonly affects the anogenital skin of postmenopausal women. The aetiology of the condition is multifactorial. The most common presenting symptom is itching. Lichen Sclerosus has a characteristic appearance. Diagnosis is made with vulvar biopsy. Treatment is important and the regimen most often includes topical corticosteroid ointments. Lifetime surveillance of the skin is imperative because of the increased risk of squamous cell carcinoma in patients with Lichen Sclerosus.

  • Vulvar Lichen Sclerosus
    American Journal of Clinical Dermatology, 2004
    Co-Authors: Yolanda R Smith, Hope K. Haefner
    Abstract:

    Lichen Sclerosus is a chronic disorder of the skin and mucosal surfaces, and is most commonly seen on the female genital skin. It also occurs on other areas of the body. Any age group may be affected, although it is seen more often in elderly women. The exact cause of Lichen Sclerosus is unknown. There have been reports of family members with Lichen Sclerosus; thus it may have a genetic link. There is also the possibility of an autoimmune connection. Currently, ultra-potent topical corticosteroids are the medical treatment of choice. Other treatments that have been utilized for this condition include testosterone, progesterone, tacrolimus, surgery, and phototherapy. Surgery should be reserved for symptomatic patients who fail to respond to multiple medical treatments, as there is a high recurrence rate following surgery. The risk of developing squamous cell carcinoma of the vulva approaches 5% in women with vulvar Lichen Sclerosus, and therefore close surveillance by the healthcare provider and patient is needed. This review discusses the history, clinical features, pathophysiology, and treatment of Lichen Sclerosus of the vulva, as well as pregnancy issues and sexual function in patients with this condition. In addition, problems specific to children with Lichen Sclerosus are reviewed.

  • Vulvar Lichen Sclerosus : pathophysiology and treatment.
    American journal of clinical dermatology, 2004
    Co-Authors: Yolanda R Smith, Hope K. Haefner
    Abstract:

    Lichen Sclerosus is a chronic disorder of the skin and mucosal surfaces, and is most commonly seen on the female genital skin. It also occurs on other areas of the body. Any age group may be affected, although it is seen more often in elderly women. The exact cause of Lichen Sclerosus is unknown. There have been reports of family members with Lichen Sclerosus; thus it may have a genetic link. There is also the possibility of an autoimmune connection. Currently, ultra-potent topical corticosteroids are the medical treatment of choice. Other treatments that have been utilized for this condition include testosterone, progesterone, tacrolimus, surgery, and phototherapy. Surgery should be reserved for symptomatic patients who fail to respond to multiple medical treatments, as there is a high recurrence rate following surgery. The risk of developing squamous cell carcinoma of the vulva approaches 5% in women with vulvar Lichen Sclerosus, and therefore close surveillance by the healthcare provider and patient is needed. This review discusses the history, clinical features, pathophysiology, and treatment of Lichen Sclerosus of the vulva, as well as pregnancy issues and sexual function in patients with this condition. In addition, problems specific to children with Lichen Sclerosus are reviewed.

Anthony Hall - One of the best experts on this subject based on the ideXlab platform.

  • Penile Lichen Sclerosus (balanitis xerotica obliterans)
    BJU International, 2011
    Co-Authors: David Clouston, Anthony Hall, Nathan Lawrentschuk
    Abstract:

    What's known on the subject? and What does the study add? The clinical presentation and complications of Lichen Sclerosus are well known. What is less well known is the true incidence of the condition. The published figures are all based on attendance at general medical clinics or specialist clinics, but it is likely that the true incidence is much higher than this reported incidence as many men will not present to the doctor for treatment. The other uncertainty is the relationship of Lichen Sclerosus to the subsequent development of cancer of the penis. As pointed out in the paper, it is likely that between 4% and 8% of men with this condition will develop squamous cell cancer of the penis. However, it is unclear if Lichen Sclerosus itself causes the development of squamous cell cancer or if it is due to coexistent infection with human papillomavirus. This review provides a concise summary of the clinical and pathological features of the disease and describes its current medical and surgical treatment. It brings together a number of papers which have addressed the association of Lichen Sclerosus with squamous cell carcinoma of the penis and shows that the likely incidence of carcinoma is approximately 4–8% in men with this condition. SUMMARY Penile Lichen Sclerosus, also known as balanitis xerotica obliterans, is a chronic inflammatory condition of the penis which can occur at all ages. The inflammation leads to the formation of white plaques most commonly on the foreskin or penis, and can lead to inability to retract the foreskin or blockage to the flow of urine. Cancer may occur rarely. Penile Lichen Sclerosus is a progressive, sclerosing, inflammatory dermatosis of the glans penis and foreskin which is of uncertain aetiology. Recent studies have shown a link between Lichen Sclerosus and squamous cell carcinoma of the penis. In this review, we discuss the clinical presentation, pathology and current approach to treatment of this condition.

  • Penile Lichen Sclerosus (balanitis xerotica obliterans).
    BJU international, 2011
    Co-Authors: David Clouston, Anthony Hall, Nathan Lawrentschuk
    Abstract:

    What's known on the subject? and What does the study add? The clinical presentation and complications of Lichen Sclerosus are well known. What is less well known is the true incidence of the condition. The published figures are all based on attendance at general medical clinics or specialist clinics, but it is likely that the true incidence is much higher than this reported incidence as many men will not present to the doctor for treatment. The other uncertainty is the relationship of Lichen Sclerosus to the subsequent development of cancer of the penis. As pointed out in the paper, it is likely that between 4% and 8% of men with this condition will develop squamous cell cancer of the penis. However, it is unclear if Lichen Sclerosus itself causes the development of squamous cell cancer or if it is due to coexistent infection with human papillomavirus. This review provides a concise summary of the clinical and pathological features of the disease and describes its current medical and surgical treatment. It brings together a number of papers which have addressed the association of Lichen Sclerosus with squamous cell carcinoma of the penis and shows that the likely incidence of carcinoma is approximately 4-8% in men with this condition. Penile Lichen Sclerosus, also known as balanitis xerotica obliterans, is a chronic inflammatory condition of the penis which can occur at all ages. The inflammation leads to the formation of white plaques most commonly on the foreskin or penis, and can lead to inability to retract the foreskin or blockage to the flow of urine. Cancer may occur rarely. Penile Lichen Sclerosus is a progressive, sclerosing, inflammatory dermatosis of the glans penis and foreskin which is of uncertain aetiology. Recent studies have shown a link between Lichen Sclerosus and squamous cell carcinoma of the penis. In this review, we discuss the clinical presentation, pathology and current approach to treatment of this condition. © 2011 THE AUTHOR. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

Fenella Wojnarowska - One of the best experts on this subject based on the ideXlab platform.

  • Lichen Sclerosus premenarche: autoimmunity and immunogenetics
    The British journal of dermatology, 2000
    Co-Authors: J.j. Powell, P. Marren, Fenella Wojnarowska, S. Winsey, Kenneth I. Welsh
    Abstract:

    Lichen Sclerosus is among the most frequently seen paediatric vulval disorders. In adults a strong association between Lichen Sclerosus and autoimmune diseases, and also with HLA class II locus DQ7, has been well demonstrated in women and a weaker association in men. These associations have not previously been studied in children, although in other autoimmune diseases, the HLA associations have been strongest in children. We performed HLA tissue typing and looked for autoimmune associations in a group of 30 children with vulval Lichen Sclerosus. HLA DQ7 was present in 66% of female children with Lichen Sclerosus compared with 31% in controls. Previous studies reported DQ7 in 51% of adult female patients and 45% of male patients. Sixteen per cent of the children were homozygous for DQ7 as opposed to 5% of controls. In the childhood group, only 4% had another autoimmune disease, but 56% of their parents or grandparents did. Age differences make comparison difficult, but the family history of autoimmunity appears to be strong in the early-onset group, in addition to the stronger association with DQ7.

  • Do plasminogen activators play a role in Lichen Sclerosus
    Clinical and experimental dermatology, 2000
    Co-Authors: A.m. Farrell, D. Dean, F.m. Charnock, Fenella Wojnarowska
    Abstract:

    The histological changes of Lichen Sclerosus suggest that significant remodelling of the extracellular matrix is occurring. As the proteases of the plasminogen activator system have been implicated in tissue remodelling, cell migration and tumour invasion, we performed an immunohistochemical study to look for evidence of alteration in the expression of plasminogen/plasmin, urokinase-type plasminogen activator, tissue-type plasminogen activator and alpha2-antiplasmin in biopsies of clinically typical vulval Lichen Sclerosus obtained from 11 untreated adult women. Normal vulva obtained from gynaecological procedures and samples of the patients' uninvolved thigh tissue were used as controls. No significant difference was seen in the staining pattern between the Lichen Sclerosus tissue and control tissue. However, although we found no immunohistochemical evidence that the plasminogen activator system is involved in the pathogenesis of vulval Lichen Sclerosus, it may be that other proteases are involved.

  • Cicatricial pemphigoid and Lichen Sclerosus
    Journal of the European Academy of Dermatology and Venereology, 1996
    Co-Authors: P. Marren, V. Neild, P. Frith, Fenella Wojnarowska
    Abstract:

    Abstract Two patients with clinical and laboratory evidence of co-existing Lichen Sclerosus and cicatricial pemphigoid are reported. Autoimmune bullous diseases affecting the vulva may mimic Lichen Sclerosus but in these two patients both diseases were present. These two diseases have not previously been reported simultaneously to date.

  • Mucosal Lichen Sclerosus/Lichen planus overlap syndromes.
    The British journal of dermatology, 1994
    Co-Authors: P. Marren, P.r. Millard, Y. Chia, Fenella Wojnarowska
    Abstract:

    Lichen Sclerosus and Lichen planus affecting cutaneous sites are easily distinguishable clinical. Clinical signs on mucosal sites, however, may not allow differentiation between these diseases, and reliance is frequently placed on histopathological findings. We report a series of seven patients with clinical evidence of coexisting vulval Lichen Sclerosus and Lichenoid oral lesions. All patients had vulval biopsies, and four had oral biopsies. Histology of all the vulval biopsy specimens showed features consistent with Lichen Sclerosus. Two of these patients developed vulval intraepithelial neoplasia during the course of their disease, and one progressed to a well-differentiated squamous carcinoma. Histology of the oral lesions showed features that were predominantly those of Lichen planus. There are, however, few reports of histologically proven oral Lichen Sclerosus. Variations in histopathological descriptions of Lichen Sclerosus, depending on duration of disease, have been reported, particularly with regard to the position of the inflammatory infiltrate in relation to the dermo-epidermal junction. We believe that these patients may have oral Lichen Sclerosus, or at the very least make up a distinctive group who need to be identified and followed up, as their risk of oral dysplasia is unknown.

  • Bullous and haemorrhagic Lichen Sclerosus with scalp involvement.
    Clinical and experimental dermatology, 1992
    Co-Authors: P. Marren, P.r. Millard, D. De Berker, Fenella Wojnarowska
    Abstract:

    We describe a patient who developed a generalized blistering eruption due to Lichen Sclerosus and who was observed to have scalp involvement. Both are unusual manifestations of this disease which merit consideration. Lichen Sclerosus is an uncommon disease that most frequently affects the external genitalia of perimenopausal women. The aetiology is unknown. Approximately 20% of affected patients have extragenital lesions that present as small, ivory, shiny round macules or papules that later become atrophic; extragenital lesions are generally asymptomatic. Bullous and haemorrhagic forms may occur but these are generally localized and reports of extensive or generalized involvement are rare. We describe an elderly woman with generalized bullous Lichen Sclerosus. As an incidental finding, she was observed to have Lichen Sclerosus affecting her scalp. This has rarely been described and it would appear that she is the third reported case of scalp involvement.