Understanding the impact of life with vulval lichen sclerosus

Sivalingam, Vanitha N.; Tamber, Kajal

doi:10.1111/bjd.21846

Cited by 2 publications

(4 citation statements)

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“…Так, в клинических рекомен-дациях по онкологии от 2015 года указывается, что дистрофические поражения вульвы занимают от 2 до 10% в структуре гинекологических заболеваний [11]. Тем более отсутствует статистика распространенности СЛВ среди взрослых женщин (старше 18 лет) не только по возрастам, но и, что еще более важно, по времени возникновения или дебюта заболевания, поскольку период с этого момента до установления диагноза СЛВ иногда может достигать нескольких десятков лет [12,13].…”

Section: Discussionunclassified

“…Проведенный нами анализ возраста дебюта СЛВ подтвердил результаты последних зарубежных исследований о том, что данное заболевание напрямую не связано с каким-либо определенным возрастом женщины, а также с постменопаузальным периодом [10,12,13]. Это позволяет рассматривать интимно-бытовые анамнестические факторы, а именно преобладание каких-либо из них в течение длительного времени (до возникновения и с момента возникновения СЛВ), у пациенток любого возраста.…”

Section: Discussionunclassified

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Household and hygienic risk factors and their impact on the development and course of lichen sclerosis of the vulva

Kolesnikova,

Zharov,

Penzhoyan

et al. 2023

WHAR

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Objective: To identify statistically significant household and hygienic factors that influence the risk of developing lichen sclerosus of the vulva. Design: Cross-sectional cohort comparative case-control study. Materials and methods. The study involved 344 patients with sclerotic lichen of the vulva aged 20 to 70 years and 60 women of the control group of the same age. Based on the survey of women of the main and control groups, a comparative analysis of intimate and household anamnestic factors of the development of sclerotic lichen of the vulva was carried out according to several categorical indicators characterizing the features of sexual life, intimate hygiene, underwear of the patient, etc. Statistical correlation analysis of the obtained anamnestic data of the subjects was performed using the Spearman correlation coefficient (correlations were considered statistically significant at R > 0.15), the Mann -Whitney U—test and the Student t-test (differences were considered statistically significant at p < 0.05). Results. The study established statistically significant household and hygienic risk factors for the development of sclerotic lichen of the vulva: regular shaving and other types of depilation of hair in the vulva (R = –0.38); wearing underwear mainly with a narrow gusset (R = –0.32); intimate hygiene only with water (R = –0.27); wearing underwear mainly with rough seams, lace (R = –0.17); intimate hygiene with perfumes (R = –0.17), p < 0.05. Statistically significant household and hygienic factors that reduce the risk of developing and progressing sclerotic lichen of the vulva have been identified: the use of pharmaceutical products for intimate hygiene containing lactic acid (R = 0.73); wearing underwear made of natural fabrics (R = 0.42), absence or rare shaving /depilation of the vulva (R = 0.21); regular sexual life (R = 0.18), p < 0.05. Conclusion. The data obtained on the influence of household and hygienic factors on the risk of development and the nature of the course of sclerotic lichen of the vulva not only confirm, but also significantly expand and refine the results of foreign studies. Elimination of negative triggers and compliance with favorable household and hygienic conditions can become the basis for the prevention of the occurrence of sclerotic lichen of the vulva and the development of complications of this disease. Keywords: sclerotic lichen, vulva lichen, risk factors, intimate hygiene, vulva, prevention, emollients.

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Section: Discussionunclassified

Household and hygienic risk factors and their impact on the development and course of lichen sclerosis of the vulva

Kolesnikova,

Zharov,

Penzhoyan

et al. 2023

WHAR

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“…LS negatively impacts on the psychosexual health of both women and men ( 9 , 61 ). The late diagnosis of LS leads to frustration and delays in starting an adequate treatment ( 222 ). Both sexes experience a reduction in QoL in LS, but they might experience the symptomatology differently ( 223 ).…”

Section: Complicationsmentioning

confidence: 99%

“…Both sexes experience a reduction in QoL in LS, but they might experience the symptomatology differently ( 223 ). Through DLQI assessment, VLS diminishes QoL and correlates with sexual functioning impairment, mostly attributed to the physical symptoms of LS and the feelings of embarrassment, anxiety, and stigma around open discussion of genital conditions ( 222 , 223 ). More than a half of male and female LS patients experienced pain during sexual intercourse, but complaints about LS were higher in women ( 223 , 224 ).…”

Section: Complicationsmentioning

confidence: 99%

Lichen sclerosus: The 2023 update

et al. 2023

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Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. Postmenopausal women are predominantly affected and, to a lesser extent, men, prepubertal children, and adolescents. The etiology of LS is still unknown. Hormonal status, frequent trauma and autoimmune diseases are well-known associations for LS, yet infections do not seem to be clear risk factors. LS pathogenesis involves factors such as a genetic predisposition and an immune-mediated Th1-specific IFNγ-induced phenotype. Furthermore, there is a distinct expression of tissue remodeling associated genes as well as microRNAs. Oxidative stress with lipid and DNA peroxidation provides an enabling microenvironment to autoimmunity and carcinogenesis. Circulating IgG autoantibodies against the extracellular matrix protein 1 and hemidesmosome may contribute to the progression of LS or simply represent an epiphenomenon. The typical clinical picture includes chronic whitish atrophic patches along with itching and soreness in the vulvar, perianal and penile regions. In addition to genital scarring, and sexual and urinary dysfunction, LS may also lead to squamous cell carcinoma. Disseminated extragenital LS and oral LS are also reported. The diagnosis is usually clinical; however, a skin biopsy should be performed in case of an unclear clinical picture, treatment failure or suspicion of a neoplasm. The gold-standard therapy is the long-term application of ultrapotent or potent topical corticosteroids and, alternatively, topical calcineurin inhibitors such as pimecrolimus or tacrolimus. Collectively, LS is a common dermatological disease with a so far incompletely understood pathogenesis and only limited treatment options. To foster translational research in LS, we provide here an update on its clinical features, pathogenesis, diagnosis and (emerging) treatment options.

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Understanding the impact of life with vulval lichen sclerosus

Abstract: Linked Article: Arnold et al. Br J Dermatol 2022; 187:909–918.

Cited by 2 publications

References 4 publications

Household and hygienic risk factors and their impact on the development and course of lichen sclerosis of the vulva

Household and hygienic risk factors and their impact on the development and course of lichen sclerosis of the vulva

Lichen sclerosus: The 2023 update

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