Derm News: 2007.3(9)

Clinical review of 202 patients with vulval lichen sclerosus: A possible association with psoriasis

Australasian Journal of Dermatology 48 (1), 28-31.
Susan Simpkin, Amanda Oakley

Background

Two hundred and two patients with clinically typical or biopsy-confirmed vulval lichen sclerosus were reviewed either at consultation (75%) or by retrospectively examining their chart. At diagnosis, 79% were 50 years or older. Ninety-six per cent complained of itching, pain and/or dyspareunia.

Lichen sclerosus most often affected the labia minora and perineum but 50% had perianal and 13% had extragenital disease. Thirty-five patients gave a history of psoriasis (17%), which affected the vulval area in 10.

Thyroid disease was reported in 39 patients (19%), and 33 gave a family history of thyroid disease. Of those tested (142), 20% had elevated thyroid antibodies. Topical clobetasol propionate was very effective but at least intermittent treatment was required long term in 85%.

At follow up, 101 of 185 patients (56%) were asymptomatic but 22 (12%) continued to have moderate-to-severe symptoms. Thyroid disease and psoriasis are common associated conditions.

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The Derm News service provided by the Editorial Consultants of Skin Therapy Letter^© and its founding editor Dr. Stuart Maddin.