Hi doctor, I have been diagnosed with lichen sclerosus around my vulva a few months ago through biopsy. I am regularly using Dermol 500 lotion instead of soap to wash the area and applying Dermovate cream. However, I have developed a cut in the skin at the back of my vagina, which is not healing now. This is very painful to go to the toilet and also means that sex is definitely not possible. I have had this cut for about 10 days now. I have seen the GP who has simply given me Hydromol ointment and it still remains the same. In addition, my partner has also got a sore bit on his penis and we are wondering if the two could possibly be related. Could this be friction burns? My partner and I are 49 and 50. So, feel ridiculous to be having these issues and very frustrating. He is embarrassed to go to the doctors about his cut. I am unsure if it is my fault related to my condition or friction or something else. Is there any better medicated solution to aid healing rather than moisturizer based solutions? I have attached photos for your reference. Thanks in advance.
Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. Thanks for taking time to upload latest pictures (attachment removed to protect patient identity) of the lesions on both partner's genitalia. Lichen sclerosus is a benign condition but it may also transform into squamous cell carcinoma if not treated properly.  Yes, penile lesion may be related to the vulvar lesion. But, lichen sclerosus is not a contagious disease. Did you get the biopsy of the lesions shown in the pictures, both your's and your partner's? If not, please get them tested.  You need not worry as all the symptoms are related to this disease. Sexual intercourse and urination problems are all due to this lesion and this is a real pain when a patient gets this kind of fissure along with itching of lichen. If not treated it may cause permanent scarring and that is very painful situation. Biopsy of the lesions on penis and vulva, highly recommended. Lichen sclerosus. 1. Patient education, it is a long-term disease and may relapse even after total relief. You need to be very calm and consistent in treatment. 2. Hydrocortisone ointment (topical Clobetasol propionate) is the treatment of choice to reduce scarring and to get relief from fissuring. It will reduce progression of the disease. 3. Avoid scratching and keep the vulva and penis clean and dry. 4. If ever topical corticosteroid fails we add intralesional corticosteroids, or I usually go for a second line therapy as calcineurin inhibitors. Stay away from sexual intercourse until you get symptom free. For further queries consult a general practitioner online.--->