Does Lichen Sclerosus Increase the Risk of STIs and Urological Diseases?

Q: Does Lichen Sclerosus Increase the Risk of STIs and Urological Diseases?

Dear readers： Regarding whether reactive arthritis increases the risk of sexually transmitted infections, the response is as follows： 1. Refer to information related to reactive arthritis. 2. It is usually observed following gastrointestinal infections (such as

Does Listeriosis increase the risk of sexually transmitted infections?

Hello, doctor.
I've heard that Lichen Sclerosus often co-occurs with sexually transmitted infections (STIs) and urinary diseases.
Does this mean that patients with Lichen Sclerosus are particularly susceptible to infections like STIs or urinary diseases? Are there specific STIs that they are more likely to contract, or is their risk similar to that of the general population? If they regularly take immunomodulators, will that reduce their susceptibility to infections?

Niming, 20~29 year old female. Ask Date: 2017/05/06

Dr. Liao Zhongxin reply Internal Medicine

Dear readers:
Regarding whether reactive arthritis increases the risk of sexually transmitted infections, the response is as follows:
1.
Refer to information related to reactive arthritis.
2.
It is usually observed following gastrointestinal infections (such as diarrhea, dysentery, etc.) or urinary tract infections (for example, sexually transmitted infections acquired through prostitution) occurring approximately one to three weeks prior, presenting as acute arthritis.
This condition predominantly affects the lower limb joints, particularly the knee, ankle, and foot joints, often exhibiting an asymmetric distribution.
3.
The pathophysiology causing reactive arthritis is still not fully understood; however, it is known to frequently occur after infections with Chlamydia species, Salmonella, Shigella, Yersinia, and Campylobacter.
P.S.
For treatment, please consult a medical facility with expertise in immunology and rheumatology.
Thank you!

Reply Date: 2017/05/06

More Info

Lichen sclerosus (LS) is a chronic inflammatory skin condition that primarily affects the genital and anal areas, although it can occur in other parts of the body as well. It is characterized by white patches of skin that can lead to scarring and changes in the skin's texture. One of the concerns surrounding lichen sclerosus is its potential association with an increased risk of sexually transmitted infections (STIs) and urological diseases.

To address your question, individuals with lichen sclerosus may indeed have a higher susceptibility to certain infections, including STIs and urological diseases. This increased risk can be attributed to several factors:
1. Skin Integrity: Lichen sclerosus can cause thinning and fragility of the skin, particularly in the genital area. This compromised skin barrier may make it easier for pathogens to enter the body, thereby increasing the risk of infections.

2. Chronic Inflammation: The inflammatory nature of lichen sclerosus can lead to changes in the local immune response. Chronic inflammation may alter the normal flora of the genital area, potentially allowing for the overgrowth of harmful bacteria or viruses.

3. Sexual Activity: Individuals with lichen sclerosus may experience discomfort or pain during sexual activity due to the condition. This can lead to changes in sexual behavior, such as reduced condom use, which can increase the risk of STIs.

Regarding specific STIs that may be more prevalent in individuals with lichen sclerosus, there is no definitive list. However, any STI that can be transmitted through skin-to-skin contact or bodily fluids could potentially be a concern. Common STIs include chlamydia, gonorrhea, syphilis, and human papillomavirus (HPV). The risk of these infections may not be significantly different from the general population, but the presence of lichen sclerosus could complicate the clinical picture.

As for the use of immunomodulatory medications, such as corticosteroids or other immune-modulating agents, these treatments can help manage the symptoms of lichen sclerosus and reduce inflammation. However, they may also have implications for the immune system's ability to respond to infections. While these medications can help control the condition, they do not guarantee immunity from infections. In fact, some immunosuppressive therapies can increase the risk of infections, so it's essential to discuss the risks and benefits of any medication with your healthcare provider.

In summary, while lichen sclerosus may be associated with an increased risk of STIs and urological diseases due to skin integrity and immune response factors, it does not mean that every individual with the condition will experience these issues. Regular monitoring, practicing safe sex, and maintaining open communication with healthcare providers are crucial for managing both lichen sclerosus and the associated risks of infections. If you have concerns about your risk of STIs or other urological issues, it is advisable to consult with a healthcare professional who can provide personalized guidance based on your medical history and current condition.

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