Lichen sclerosus (LS) is a chronic, inflammatory disorder of genital and extragenital skin. LS is a debilitating disease, causing itch, pain, dysuria and restriction of micturition, dyspareunia, and significant sexual dysfunction in women and men. Many findings obtained in recent years point more and more towards an autoimmune-induced disease in genetically predisposed patients and further away from an important impact of hormonal factors. Preceding infections may play a provocative part. Trauma and an occlusive moist environment may act as precipitating factors. Potent and ultrapotent topical corticosteroids still head the therapeutic armamentarium. Topical and systemic retinoids may be useful in selected cases.
IV Ketamine Infusion Therapy is now being used to treat LS, with very high success in initial trials. Surgery is restricted to scarring processes leading to functional impairment. In men, circumcision is effective in the majority of cases, but recurrences are well described. Anogenital LS is associated with an increased risk for squamous cell carcinoma of the vulva or penis.
Sherry Johnson, Dr. Ashraf Hanna’s patient, suffered from severe Lichen Sclerosus and CRPS/RSD for years. The pain was so intense, she was bedridden. After beginning IV Ketamine Infusion Therapy at the Florida Spine Institute with Dr. Hanna, her pain is reduced, her skin healed and she now has her quality of life back.