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Noticed white spots near pubic area. Suggested as Litchen Sclerosus and taking medicines. Scars are left behind. Suggest the treatment?

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My sister (age 32) is noticing white spots near the pubic area. She consulted a doctor who suggested this may be 'Litchen Sclerosus', prescribed some drugs (tricot injection, propyjol NS). She observed that the scars go away while on medicine but immediately come back once it stopped. Doctor did not ask for any blood test.
I am writing to get a second opinion whether the diagnosis is correct. If so then why it is coming back. What she should do, or is there any proper treatment and how long it should take to cure.
Posted Sat, 31 Aug 2013 in Women's Health
Answered by Dr. Vaishalee Punj 1 hour later

Thanks for posting your query on XXXXXXX

Lichen sclerosis is mostly a clinical diagnosis, but when in doubt we can always perform a biopsy of the lesion. In fact a biopsy is a good test as it can help rule out ominous causes of such white spots.

If she can describe the white spots present or if she can upload a photo of the lesion, I will be better able to help. White spots can also be due to a simple fungal infection, in which case a topical anti-fungal like clotrimazole or miconazole is good enough.

If it is Lichen sclerosis then treatment of choice is to apply a high potency steroid like Clobetasol. Clobetasol is one of the components of propyzole-nf that she is taking. In my experience it does keep coming back after discontinuing treatment. Thus long-term treatment is usually required. Also repeat biopsies are advisable since 4% of Lichen sclerosis may develop into squamous cell cancer.

Let me know if you need further clarification.

Dr Vaishalee
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