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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are blood blisters and extreme itchiness a symptom of vitiligo or lichen sclerosis?

Firstly I am 32, I had hyperthyroidisim since I was 18. I had a full thyroidectomy when I was 25. I developed Vitiligo during that time but only a mild case(a few spots on my arm and face that have never spred) in the last year and a half I have developed white spots around my anus. It gets extremely itchy and I have also noticed small blood blisters present on my labia. I have just returned home from my womens health check and the lady who looked it over was sure I had Lihen Sclerosis so she called for the dr to have a look to get a referal to see a gynecologist but she disagreed because the skin isnt hard and thinks it is Vitiligo and gave me an anti-fungal cream to apply. Are blood blisters and extreme itchiness a symptom of Vitiligo or Lichen Sclerosis? Should I get a second opinion?
Fri, 27 Mar 2015
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Dermatologist 's  Response
Hello. Thank you for writing to us.

Itching and soreness is a feature of lichen sclerosis et atrophicus (LSeA). There might be erosions due to scratching.
Vitiligo, on the other hand is completely asymptomatic.
LSeA may affect genitals as well as anal area. These patches are usually Ivory white in color and are associated with atrophy.
The atrophy can be appreciated as crinkled appearance of epidermis when pinched between fingers.
On genital skin this atrophy manifests as dryness, itching and soreness. The vaginal opening may also get stenosed and there may be pain during intercourse.
In doubtful cases a skin biopsy is confirmatory.

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