Lichen sclerosus |
Case 1:
Mrs E., born in 1939, presented in 2005 with lichen sclerosus of the labia, which had been diagnosed by a dermatologist in 2003. She had many symptoms, but was particularly troubled by burning and itching of the labia caused by a whitish rash. The burning was very intense, worse in bed, worse at night, worse with heat. She had tried several corticosteroid ointments, but none helped. Her symptoms had worsened after two years of this treatment. |
|
The gynaecological history shows that she had difficulty conceiving because of a narrowing of the fallopian tubes. Nevertheless she became pregnant spontaneously and is happy with her daughter.
She reached menopause at 55. At 58 she had another episode of bleeding. She underwent curettage, but the gynaecologist could not determine a cause for the bleeding.
She is a warm-natured, hard-working woman. She has always had a lot of energy. She worked with her husband in their own shop; they had long working hours, but she was always full of energy. She still wants to do sport, but finds it difficult; cycling in particular is impossible because of the painful rash. She wants to be active and exercise every day.
In 2003 her husband had treatment for prostate cancer: the implantation of "seeds" (radioactive particles with a short half-life). They shared the same bed during all the months of his treatment, and her condition began during that time. It began with itching, then intense burning and itching with white discolouration and hardening of the labia. On examination I noticed a white, hard induration of the labia and the vaginal opening.
Treatment: because of the presumed cause of the rash, the rash itself with burning and itching, and her energy levels, I decided to give her Radium bromatum 200K, once a month.
Follow-up:
After the remedy was given the rash initially worsened, became more active and burned more intensely, but then the symptoms subsided very quickly. After 2 months the itching was better and the rash had markedly decreased. After 5 months the itching had gone and the white patches were almost gone.
After 10 months the lichen sclerosus was completely healed: she had no more white patches, no itching or burning, and could cycle again without discomfort.
Case 2:
Mr B., born in 1958, presented in 2006 with lichen sclerosus et atrophicus of the penis. He had hardened white patches that were painful, itchy and burning, and the skin was fissured. He had the impression that the skin was progressively shrinking; he experienced pain after intercourse. He had the sensation that his skin was being eaten away from the inside.
He had suffered from this problem for 3 years. It began after treatment for abdominal pain. He had multiple X-rays and several CT scans of the abdomen; the only diagnosis found was irritable bowel syndrome. He frequently suffered severe cramping pains, rumbling and a feeling of tension in the abdomen.
Mr B. is a hard-working man. He owns a furniture shop and, according to his wife, works day and night. He is rather shy and reserved and feels guilty when he takes leisure time for himself!
Treatment: because of the possible cause and the sclerotic rash I prescribed Radium bromatum 12K, two globules once daily.
Follow-up:
The itching and the rash diminished markedly within 2 months. After 8 months there were no more problems, and he only rarely needed Radium bromatum 12K when he felt an itch. The abdominal pains are much better, he no longer has cramps. Since 2006 the lichen sclerosus has not recurred.
|
Lichen sclerosus and atrophicus
|
Case 3:
Mrs M., born in 1958, came for treatment in 2008 for circumscribed scleroderma (morphea). It began in 2005 initially on the lower abdomen and later spread to the arms and legs. She was treated with methotrexate for 3 months at first, but during that time the rash progressively worsened. She then received steroid ointments, which were also ineffective.
|
|
The rash begins with pinpoint bluish-red discolouration of the skin, which then spreads: the whole leg and arm become bluish-red. The rash is painful and burns and feels hot and glowing. It feels as if someone is pricking you with a needle. The skin hardens, the hair falls out, and if the rash persists for several months it acquires a shiny, hardened appearance. New spots continue to appear on her body, especially on the abdomen.
M. is a hard-working woman; she is a mother of three and works as a nurse in a residential home for the elderly. She is shy and reserved, especially when she is among many people. When she was younger she was even afraid of strangers. She is very active: she cycles to work and walks her dogs after work.
A year before the rash began she had multiple X-rays and various CT scans because of an ovarian cyst. She also underwent an examination with radioactive isotopes.
Treatment: Radium bromatum 200K, once every 2 weeks.
Follow-up:
After 2 months the skin was already much improved, less stiff and indurated. The stabbing sensations in the legs disappeared, as did the itching and burning. No new lesions developed. After 5 months the existing patches were becoming smaller and the skin was smoothing again, without itching or burning. No more stabbing pain.
Now, 2 years after treatment (in the last year she took Radium bromatum MK once a month), the patches are almost completely gone, as are the pains and the itching. Skin colour has almost normalised and the hair has begun to grow back! The dermatologist had told her her hair would never regrow! She still has a lot of energy and her self-esteem has greatly improved.
|
|
Photos: Wikipedia: Lichen sclerosus / Dermis.net: Lichen sclerosus and atrophicus
Category: Cases
Keywords: Lichen sclerosus, hard-working, radiotherapy, X-ray, CT
Remedy: Radium bromatum
|
