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




Abstract

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

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Citation: SI Surkichin., et al. “Modern Concepts of Lichen Sclerosus of the Vulva”. EC Gynaecology 11.3 (2022): 49-55.

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