Review Article
Volume 11 Issue 3 - 2022
Modern Concepts of Lichen Sclerosus of the Vulva
SI Surkichin1*, LS Kruglova1, IA Apolikhina2, RYu Mayorov1 and M Avin3
1Central State Medical Academy of the Administrative Department of the President of the Russian Federation, Moscow, the Russian Federation
2National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Moscow Russian Federation
3Medical Center “Stolitsa”, Moscow, Russian Federation
*Corresponding Author: SI Surkichin, Central State Medical Academy of the Administrative Department of the President of the Russian Federation, Moscow, the Russian Federation.
Received: December 20, 2021; Published: February 14, 2022


Lichen sclerosus is a chronic inflammatory disease of mucous membrane, characterized by hypopigmentation and skin atrophy. Morbidity in women has two peaks: the first - between 8 and 13 years, the second - in the fifth and sixth decades. Average age at diagnosis ranges from 52 up to 60 years old. The pathogenesis of lichen sclerosus is based on the infiltration of activated T cells that synthesize interleukin 4 (IL-4) and transforming growth factor β (TGF β). These cytokines activate fibroblasts, which produce altered collagen, leading to fibrosis. The diagnosis is based on a thorough history, which includes information about the presence of autoimmune diseases in the patient and his family, examination of the mucous membranes, extragenital skin, as well as gynecological examination. Thus, the diagnosis of lichen sclerosus is usually is clinical. For genital lichen sclerosus, the gold standard of treatment is a three-month use of topical glucocorticoids (strong or very strong). Symptoms improve, as a rule, by 75–95%. More often than others, clobetasol propionate 0.05% is used in the form of an ointment or cream 1-2 times a day for the first month, during the second month - every other day, within third month - 2 times / week. As a maintenance therapy, glucocorticoid ointment is used 1-2 times / month, and 0.1% mometasone furoate ointment may require application 2-3 times / week. Second-line therapy includes topical calcineurin inhibitors and imiquimod. Calcineurin inhibitors are prescribed for patients who do not tolerate topical glucocorticoids or do not respond to such treatment. Vulvar Cancer Risk Remains Increased throughout the woman’s life, therefore the patient must see a doctor every 6-12 months, provided that symptoms have stabilized, there is no sexual impairment, and there is no further anatomical deformity.

Keywords: Modern Concepts; Lichen Sclerosus


  1. Powell JJ and Wojnarowska F. “Lichen sclerosus”. Lancet9166 (1999): 1777-1783.
  2. Birenbaum DL and Young RC. “High prevalence of thyroid disease in patients with lichen sclerosus”. JRM-The Journal of Reproductive Medicine1 (2007): 28-30.
  3. Bercaw-Pratt JL., et al. “North American Society for Pediatric and Adolescent Gynecology. Clinical recommendation: pediatric lichen sclerosus”. Journal of Pediatric and Adolescent Gynecology2 (2014): 111-116.
  4. Eisendle K. “Possible role of Borrelia burgdorferi sensu lato infection in lichen sclerosus”. Archives of Dermatological5 (2008): 591-598.
  5. Powell J., et al. “Genital carriage of human papilloma virus (HPV) DNA n prepubertal girls with and without vulval disease”. Pediatric Dermatology3 (2003): 191-194.
  6. Bunker C and Shim T. “Male genital lichen sclerosus”. Indian Journal of Dermatology2 (2015): 111-117.
  7. Oyama N., et al. “Development of antigen-specific ELISA for circulating autoantibodies to extracellular matrix protein 1 in lichen sclerosus”. Journal of Clinical Investigation11 (2004): 1550-1559.
  8. Howard A., et al. “Circulating basement membrane zone antibodies are found in lichen sclerosus of the vulva”. Australasian Journal of Dermatology1 (2004): 12-15.
  9. Strittmatter HJ., et al. “Calcineurin antagonists in vulvar lichen sclerosus”. Archives of Gynecology and Obstetrics5 (2006): 266-270.
  10. Kreuter A., et al. “Association of autoimmune diseases with lichen sclerosus in 532 male and female patients”. Acta Dermato-Venereologica 2 (2013): 238-241.
  11. Goldstein AT., et al. “Prevalence of vulvar lichen sclerosus in a general gynecology practice”. JRM-The Journal of Reproductive Medicine 7 (2005): 477-480.
  12. Pérez-López FR and Vieira-Baptista P. “Lichen sclerosus in women: a review”. Climacteric 4 (2017): 339-347.
  13. Fistarol SK and Itin PH. “Diagnosis and treatment of lichen sclerosus: an update”. American Journal of Clinical Dermatology 1 (2013): 27-47.
  14. Flynn AN., et al. “Patient satisfaction of surgical treatment of clitoral phimosis and labial adhesions caused by lichen sclerosus”. The Journal of Sexual Medicine4 (2015): 251-255.
  15. Halonen P., et al. “Lichen sclerosus and risk of cancer”. International Journal of Cancer9 (2017): 1998-2002.
  16. Van de Nieuwenhof HP., et al. “Review of squamous premalignant vulvar lesions”. Critical Reviews in Oncology/Hematology2 (2008): 131-156.
  17. Bornstein J., et al. “The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) terminology of vulvar squamous intraepithelial lesions”. Journal of Lower Genital Tract Disease1 (2016): 11-14.
  18. Leeker MC., et al. “Lichen sclerosus: incidence and risk of vulvar squamous cell carcinoma”. Cancer Epidemiology, Biomarkers and Prevention8 (2016): 1224-1230.
  19. La SM., et al. “Vulvar melanoma associated with lichen sclerosus in a child: case report and literature review”. Pediatric Dermatology3 (2016): e190-194.
  20. Kirtschig G and Becker K. “Evidence-based (S3) Guideline on (anogenital) Lichen sclerosus”. Journal of the European Academy of Dermatology and Venereology10 (2015): e1-e43.
  21. Virgili A., et al. “Long-term maintenance therapy for vulvar lichen sclerosus: the results of a randomized study comparing topical vitamin E with an emollient”. The European Journal of Dermatology2 (2013): 189-194.
  22. Cooper SM., et al. “Does treatment of vulvar lichen sclerosus influence its prognosis?” Archives of Dermatological6 (2004): 702-706.
  23. Brodrick B., et al. “Influence of treatments on prognosis for vulvar lichen sclerosus: facts and controversies”. Clinics in Dermatology6 (2013): 780-786.
  24. Lewis FM., et al. “British Association of Dermatologists guidelines for the management of lichen sclerosus 2018”. British Journal of Dermatology4 (2018): 839-853.
  25. Lagos BR and Maibach HI. “Frequency of application of topical corticosteroids: an overview”. British Journal of Dermatology5 (1998): 763-766.
  26. Funaro D., et al. “A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus”. Journal of the American Academy of Dermatology1 (2014): 84-91.
  27. Wolf B., et al. “Anogenital lichen sclerosus: change of tissue position as pathogenetic factor”. Gynecologic Oncology Reports 20 (2017): 73-74.
  28. Kirtschig G. “Lichen sclerosus-presentation, diagnosis and management”. Deutsches Ärzteblatt International19 (2016): 337-343.
Citation: SI Surkichin., et al. “Modern Concepts of Lichen Sclerosus of the Vulva”. EC Gynaecology 11.3 (2022): 49-55.

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