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Feature Article

Vulval lichen sclerosus – diagnosis and treatment

Gayle Fischer

Figures

© STEVE DEBENPORT/ ISTOCKPHOTO.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY
© STEVE DEBENPORT/ ISTOCKPHOTO.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Vulval lichen sclerosus (VLS) is an important condition that occurs in women of all ages, although it is most common in those over 50 years. Significant scarring and deformity and malignant squamous neoplasia of the vulva are serious complications of untreated VLS that can potentially be prevented by early treatment with topical corticosteroids. Proactive management can modify the long-term course of the disease.

Key Points

  • Vulval lichen sclerosus (VLS) can occur at any age and is uncommon but becomes more prevalent in women over 50 years. It is probably underdiagnosed.
  • If treated inadequately it can lead to scarring and permanent deformity of the vulva.
  • Long-term maintenance treatment with topical corticosteroids is a safe option that can keep VLS in remission and potentially reduce the risk of malignancy.
  • Patients with VLS require long-term follow up even after initial remission is achieved, with a physician who is adequately experienced in managing this condition, as it may continue to silently progress or reappear without causing symptoms.
  • VLS is unrelated to sexually transmitted infections. Lichen sclerosus is a skin disease and is not infectious.

Figures

© STEVE DEBENPORT/ ISTOCKPHOTO.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY
© STEVE DEBENPORT/ ISTOCKPHOTO.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY