Clinical and morphological stages vulvar lichen sclerosus

Cover Page

Abstract


Aim. To determine leading clinical symptoms and risk factors for vulvar lichen sclerosus, identify the features of the disease in the early and late stages.

Materials and methods. The investigation included 102 patients with clinical symptoms of aged 21 to 79 (the average age was 50.6±13.9 years), 67/102 (66%) conducted punch biopsy of vulva. The control group consisted of 113 women without signs of vulvar lichen sclerosus according to clinical and anamnestic examination.

Results and discussion. Patients with VLS are overweight and obese 1 degree (BMI³26.5), have a low level of physical activity and sleep durations≤ 6.6 hours, experience stress and have low resistance to stress factors. Among gynecological diseases, patients with VLS are more often diagnosed with uterine myoma (42%) and genital endometriosis (29%). Among extragenital diseases, endocrine (54%), autoimmune (53%), diseases of the urinary system (54%) and skin (14%), benign diseases of the mammary glands (28.57%) prevail. Scars and deformations of the perineum, as a risk factor for VLS, are observed in 46.21%; 5% of women have a family history of VLS.

Conclusion. Vulvar lichen sclerosus is a multifactorial disease, divided into early and late stages. Subjective symptoms of VLS are not related to age, duration and stage of the disease. Mucosal edema is characteristic of the early stage, and the late stage is characterized by a change in the architectonics of the external genitalia. In 11% of cases, the disease has no visual changes on the vulva. In this case, the most exact diagnostic method for VLS is a histological examination, which allows doctors to establish a diagnosis even at an early stage.


Full Text

Restricted Access

About the authors

Anastasiia V. Sokolova

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Author for correspondence.
Email: urotub@yandex.ru

Russian Federation, Moscow

Graduate Student, Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Inna A. Apolikhina

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology; Sechenov First Moscow State Medical University (Sechenov University)

Email: i_apolikhina@oparina4.ru

Russian Federation, Moscow

D. Sci. (Med.), Prof., Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Sechenov First Moscow State Medical University (Sechenov University)

Nikon V. Zaitsev

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: a_sokolova@oparina4.ru

Russian Federation, Moscow

pathologist, Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Lyudmila V. Chernukha

Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: a_sokolova@oparina4.ru

Russian Federation, Moscow

dermatologist, Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

References

  1. Bleeker MC, Visser PJ, Overbeek LI et al. Lichen Sclerosus: Incidence and Risk of Vulvar Squamous Cell Carcinoma. Cancer Epidemiol Biomarkers Prev 2016; 25: 1224–30.
  2. Simpson RC, Cooper SM, Kirtschig G et al. Lichen Sclerosus Priority Setting Partnership Steering Group «Future research priorities for lichen sclerosus – results of a James Lind Alliance Priority Setting Partnership». Br J Dermatol 2019; 180 (5): 1236–7. doi: 10.1111/bjd.17447
  3. Tran DA, Tan X, Macri CJ et al. Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets. Int J Biol Sci 2019; 15 (7): 1429–39.
  4. Marfatia Y, Surani A, Baxi R. Genital lichen sclerosus et atrophicus in females: An update. Indian J Sex Transm Dis AIDS 2019; 40 (1): 6–12. doi: 10.4103/ijstd.IJSTD_23_19
  5. Kirtschig G, Becker K, Günthert A et al. Evidence-based (S3) Guideline on (anogenital) Lichen sclerosus. J Eur Acad Dermatol Venereol 2015; 29 (10): e1–e43. doi: 10.1111/jdv.13136
  6. Guarneri F, Giuffrida R, di Bari F et al. Thyroid Autoimmunity and Lichen. J Front Endocrinol 2017; 8: 146. doi: 10.3389/fendo.2017.00146
  7. Haefner HK, Welch KC, Rolston AM et al. Genomic Profiling of Vulvar Lichen Sclerosus Patients Shows Possible Pathogenetic Disease Mechanisms. J Lower Genital Tract Dis 2019; 23 (3).
  8. Goldstein AT, Marinoff SC, Christopher K, Srodon M. Prevalence of vulvar lichen sclerosus in a general gynecology practice. J Reprod Med 2005; 50: 477–80.
  9. Fistarol SK, Itin PH. Diagnosis and treatment of lichen sclerosus: An update. Am J Clin Dermatol 2013; 14: 27–47.
  10. Pugliese JM, Morey AF, Peterson AC. Lichen sclerosus: review of the literature and current recommendations for management. J Urol 2007; 178 (6): 2268–76.
  11. Halonen P, Jakobsson M, Heikinheimo O et al. Lichen sclerosus and risk of cancer. Int J Cancer 2017; 140: 1998–2002. doi: 10.1002/ijc.30621
  12. Leibowitch M, Neill S, Pelisse M, Moyal-Baracco M. The epithelial changes associated with squamous cell carcinoma of the vulva: a review of the clinical, histological and viral findings in 78 women. Br J Obstet Gynaecol 1990; 97: 1135–9.
  13. Walkden V, Chia Y, Wojnarowska F. The association of squamous cell carcinoma and lichen sclerosus; implications for follow up. J Obstet Gynaecol 1997; 17: 551–3.
  14. Latini A, Cota C, Orsini D et al. Male and female genital lichen sclerosus. Clinical and functional classification criteria. Postepy Dermatol Alergol 2018; 35 (5): 447–53. doi: 10.5114/ada.2018.77236
  15. Regauer S, Liegl B, Reich O et al. Lichen sclerosus vulvae. Die besondere Bedeutung der klinischen und histopathologischen Früherkennung [Vulvar lichen sclerosus. The importance of early clinical and histological diagnosis]. Hautarzt 2004; 55 (2): 158–64. doi: 10.1007/s00105-003-0645-8

Supplementary files

There are no supplementary files to display.

Statistics

Views

Abstract - 14

PDF (Russian) - 0

Cited-By


PlumX

Dimensions

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies