Vulvar lichen sclerosus: breaking the silence

Vulvar lichen sclerosus is a chronic inflammatory skin condition that often leads to a decreased quality of life if left undiagnosed and subsequently untreated. The etiology of the disease is still undetermined, but it is thought that genetic and autoimmune factors may predispose patients to the condition. Generally, the disease is diagnosed based on characteristic clinical presentation; however, biopsy is recommended to confirm the diagnosis. Women are not only affected physically by the disease, but mentally and emotionally as well. It is important for practitioners to be aware of the adverse effects and associated comorbidities when diagnosing and treating patients with vulvar lichen sclerosus. Earlier detection and subsequent adequate management can lead to a reduction of these adverse outcomes. Topical ultrapotent corticosteroids remain the gold standard of treatment; however, various 2nd line therapies can be used among patients whose condition is refractory to the topical ultrapotent corticosteroids. The disease is highly treatable, but long-term maintenance therapy and lifetime follow-up are imperative among all patients with this chronic and debilitating condition. (Conclusion) References