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Lichen sclerosus is a chronic skin disease that mostly affects adult women, but also men and children. It mainly occurs in the genital area and around the anus. Affected women and girls frequently report itching, pain, and burning in the involved area. Scarring after inflammation may cause fusion of the vaginal lips, narrowing of the vaginal opening, and burying of the clitoris. Sex is often painful, less pleasurable, or impossible because of the pain. Lichen sclerosus in men and boys may cause tightening of the foreskin, leading to difficulty in passing urine or painful erection. Pain on opening the bowels may also be present, causing constipation, especially in children. Treating this disease is beneficial as the symptoms can be relieved, and further damage to the genital area and around the anus may be prevented. Various topical treatments for lichen sclerosus have been devised. This review aimed to identify which topical treatments are effective and safe.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Phimosis is a condition where the foreskin cannot be fully drawn back (retracted) over the penis. Phimosis is normal at birth and often self‐corrects without needing treatment during the first three to four years of life; only 10% of three year old boys have phimosis. This is known as congenital phimosis. Phimosis can also be caused by scarring of the skin protecting the head of the penis that is caused when the foreskin cannot be retracted. Phimosis caused by scarring is estimated to occur among 0.6% to 1.5% of boys less than 18 years of age, but this type of phimosis seldom occurs among boys under five years of age. Making a distinction between types of phimosis can sometimes be difficult.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Bullous pemphigoid (BP) is the most common autoimmune blistering disease in the West. Incidence figures are not available for most parts of the world but BP appears to be rarer in the Far East. Bullous pemphigoid is usually a disease of the elderly but it can also affect younger people and children. Both sexes are similarly affected. While BP usually resolves within five years, there is a moderate death rate associated with the disease and its treatment. Oral corticosteroid drugs are the most common treatment, but may be associated with serious adverse effects, including some deaths. The most common adverse effects of oral steroids, include weight gain and high blood pressure. Long‐term use is associated with an increased risk of diabetes mellitus and decreased bone density. Topical steroids are also associated with adverse effects, such as thinning of the skin and easy bruising. The risk of experiencing adverse effects of topical steroids depends on the strength of the steroid, how long it is used for, which area of the body it is applied to, and the kind of skin problem; if a high‐strength, potent steroid is used, enough may be absorbed through the skin to cause adverse effects in the rest of the body.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Psoriasis is a common chronic skin disease with a prevalence in 2% to 3% of the population, according to European studies. Involvement of the nails occurs in about 50%. Nail psoriasis is difficult to treat, but may respond to some treatments. We aimed to review the efficacy and safety of the treatments used for nail psoriasis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Erosive lichen planus (ELP) is a condition that affects the mouth, oesophagus (food pipe or gullet), and anogenital region. It is caused by an over‐active immune system. It is often more painful and debilitating than the non‐erosive types of lichen planus. Depending on the site involved, affected individuals may experience pain, and difficulty eating; passing urine; or having sexual intercourse. Treatment is difficult and aimed at controlling symptoms, rather than cure. Several creams and tablets have been used with varying results.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Atopic eczema (atopic dermatitis or childhood eczema) is a big problem worldwide. The skin of people with atopic eczema often contains high numbers of a bacterium called Staphylococcus aureus (S. aureus).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Mild psoriasis can usually be treated effectively using medication applied directly to the skin (topical treatments). Corticosteroids and vitamin D analogues have proven to help and be well tolerated.The treatment options for psoriasis include medication applied to the skin, phototherapy, and medication that is swallowed or injected. Topical (externally applied) treatments are often effective in mild to moderate cases of psoriasis. The medications are applied to the affected areas of skin (plaques) in the form of ointments, creams, solutions or foams. The type of product used will depend on various factors, including the location of the plaque and the condition of the skin.Some people only use the medication during acute episodes of psoriasis, while others use it regularly as a long-term treatment. It is then applied to the affected areas of skin during "quieter" phases too, with the aim of preventing further flare-ups. In order to avoid side effects, steroid medications aren't applied every day, but rather on two days per week – for instance at weekends.In addition to using medicated topical treatments, people are advised to take good care of their skin, for instance by using lipid-replenishing ointments or creams (emollients) to moisturize it. The aim of this continuous basic treatment is to relieve itching and prevent the skin from drying out.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 18, 2017

Vitiligo is a chronic skin disorder characterised by patchy loss of skin colour. Some people experience itching before the appearance of a new patch. It affects people of any age or ethnicity, more than half of whom develop it before the age of 20 years. There are two main types: generalised vitiligo, the common symmetrical form, and segmental, affecting only one side of the body. Recent genetic research suggests that generalised vitiligo is, at least in part, an autoimmune condition which destroys melanocytes (pigment cells). Although our understanding of vitiligo has increased, its causes are still poorly understood. Several treatments are available. Some can restore pigment but none can cure it or prevent its spread or recurrence. Vitiligo patches can have a major psychosocial impact, especially for people with dark or tanned skin or when the face or hands are affected. People with vitiligo can be stigmatised, often experiencing low self‐esteem and a lack of self‐confidence. Children with vitiligo may be teased and bullied at school. Despite this, we found only one study assessing psychological therapy for vitiligo.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Chronic plaque psoriasis is the most common type of psoriasis. Although any part of the body may be affected, the most commonly affected sites are the elbows, knees, and scalp. 'Topical' treatments (i.e. treatments applied to the skin) are usually tried first. These include vitamin D products, topical corticosteroids, tar‐based preparations, dithranol, salicylic acid, and vitamin A products. As chronic plaque psoriasis is a long‐term condition, it is important to find out which treatments work best and what adverse effects they have. This review describes average benefits of different treatments, while recognising that individuals will vary in their experience of each treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

A lot of people are wary of steroids. If used properly, though, they rarely lead to side effects. And they are only used for acute flare-ups, not for long-term treatment. Preventive intermittent treatment with topical corticosteroids can help with frequent flare-ups.In mild eczema, a special skin care routine may be enough to keep the condition at bay. If the skin is inflamed and itchy, a topical corticosteroid ointment or cream is used on the rash too. Topical means “applied to the skin.” These products can effectively reduce the itching and inflammation. They are used until the symptoms go away. If for some reason steroids shouldn’t be used, the medications pimecrolimus or tacrolimus can be considered. These belong to a group of medications called calcineurin inhibitors. They are used if, for instance, sensitive areas such as the face or genitals are affected.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 23, 2017

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