Vulvar lichen sclerosus et atrophicus

Abstract

Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia, dysuria, and urinary or fecal incontinence. Anogenital lichen sclerosus (LS) is characterized by porcelain-white atrophic plaques, which may become confluent extending around the vulval and perianal skin in a figure of eight configuration. Thinning and shrinkage of the genital area make coitus, urination, and defecation painful. LS is not uncommon in India and present as an itchy vulvar dermatosis which a gynecologist may mistake for candidal vulvovaginitis. There is often a delay in diagnosis of VLS due to its asymptomatic nature and lack of awareness in patients as well as physicians. Embarrassment of patients due to private nature of the disease and failure to examine the genital skin properly are the other reasons for delay in diagnosis. There is no curative treatment for LS. Various medications available only relieve the symptoms. Chronic nature of the disease affects the quality of life. Proper and regular follow-up is required as there are chances of the development of squamous cell carcinoma.

<p>Vulvar Lichen Sclerosus: Current Perspectives</p>

“…1,2 This suggests that this condition is commonly unrecognized and misdiagnosed for several years. 2,5 The incidence of LS in the general population is largely unknown. A recent report from the Netherlands estimated that the incidence of histology-proven LS in women rose from 7.4 to 14.6 per 100,000 woman-years between 1991 and 2011.…”

Vaginal Atrophy and Lichen Sclerosus: Case Report

“…Betamethasone therapy with calcitriol, calcipotriene, and calcipotriene plus betamethasone may be effective in localized sclerotic events [15] . Triamcinolone acetonide injection of 20 mg into thickened hypertrophic plaques per month for 3 months reduces patients' complaints [16] .…”

“…Retinoids decrease connective tissue degeneration. However, the use of these agents is limited due to their side effects such as cheilitis, xerosis, teratogenicity, elevated liver enzymes, elevated triglycerides, and alopecia [15] .…”

Auftreten eines genitalen Lichen sclerosus et atrophicus unter Pembrolizumab-Therapie eines metastasierten malignen Melanoms

“…Es wurde eine signifikante Zunahme von CD8+-T-Zellen und regulatorischen T-Zellen beobachtet [1,15]. Die von LSA betroffene Vulva-Haut weist ein breites Spektrum an proliferativen Aktivitäten auf [7]. Die p53-und proliferierenden Zellkernantigene sind verändert, was zu Veränderungen der Proliferationsfähigkeit der Epidermiszellen führt.…”

“…Es gibt derzeit keine kurative Behandlung für Lichen sclerosus. Verschiedene Therapien können aber die Symptome deutlich lindern [7].…”