Can lichen sclerosus be diagnosed without biopsy?
Yes, most cases of lichen sclerosus are diagnosed without a biopsy. An experienced clinician usually recognises the typical appearance on examination.
Detailed Medical Explanation
Diagnosis is usually made based on the characteristic white, shiny, atrophic skin patches and any scarring. Biopsy is only necessary if the diagnosis is uncertain, if there is poor response to treatment, or if there are changes suggesting cancer. See NHS advice on clinical diagnosis: NHS.
Clinical Context
Our clinic provides specialist visual diagnosis and second opinions: Vulval Skin Conditions Clinic.
Evidence-Based Approaches
Biopsy is not routine and is only used when needed. See NHS guidelines.