ICD10CM:
L90.0 – Lichen sclerosus et atrophicus

SNOMEDCT:
895454001 – Lichen sclerosus

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• Morphea – Indurated; lilac-colored or hyperpigmented border.
• Vitiligo – Well-defined depigmentation, often not in hourglass configuration; lacks signs of atrophy (purpura, telangiectasias, fine wrinkling, and fissures).
• Lichen planus – Look for fine white streaks (Wickham striae).
• Cicatricial pemphigoid – Look for blisters and erosions, scarring, and stricture formation in later stages.
• Lichen simplex chronicus – Look for lichenification with exaggerated skin markings; may have excoriations.
• Psoriasis – Look for well-demarcated plaques on other body sites.
• Extramammary Paget disease – Look for lichenified to verrucous dry or macerated plaques.
• Sexual abuse – Disrupted hymen, may have an associated sexually transmitted disease, purpura, and bruising outside of atrophic areas; a diagnosis of lichen sclerosus does not exclude concomitant sexual abuse, and social work should investigate when suspicion is high.
• Trauma (eg, straddle injury) – No atrophy, consistent history.
• Scars – Firm, smooth, indurated plaques.
• Cutaneous candidiasis – May have erosions, but no atrophy; erythema and satellite lesions.
• Irritant dermatitis – May have postinflammatory hypopigmentation, pruritus, erythema, and erosions, but no purpura or telangiectasias.
• Bacterial vaginosis – Vulvar pruritus, but no other specific vulvar cutaneous findings.
• Bullous pemphigoid

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Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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