Peristomal lichen sclerosus: the role of occlusion and urine exposure?

Summary Background  Lichen sclerosus (LS) is a chronic inflammatory skin disorder that typically affects the anogenital area. It presents with ivory‐white atrophic patches or plaques with associated telangiectasia and occasional purpura. It has rarely been described as affecting abdominal stomas. Objectives  To investigate possible aetiological factors responsible for the development of this condition. Methods  All patients with peristomal LS were identified at a specialist stoma dermatology clinic and studied using a standardized pro forma. Results  We identified 12 patients with peristomal LS. The mean age was 72·3 years (range 47–85 years). With the exception of one patient, all our other patients had urostomies. Treatment was effective in the majority of cases. Conclusions  Peristomal LS, in our experience, is most commonly found around urostomies, and we speculate that in addition to the possible role of local trauma and occlusion, certain – as yet unidentified – constituents in the urine possibly play a role in its aetiology. It tends to respond well to corticosteroids and has not been associated with malignant transformation.