Update on Vulvar Lichen Sclerosus in Adult Population

Abstract

Vulvar lichen sclerosus is a chronic, inflammatory, and progressive disease without clear etiology, unknown prevalence, and mean diagnosis age between the fifth and sixth decade of life. Affected areas include several zones in the vulva, perineum and perineal zone, frequently leading to the characteristic “figure of eight”. The lesions have the aspect of marble white plaques and epidermal wrinkles as a pathognomonic finding. There are various theories related to its evolution that include genetic, autoimmune, infectious, local, hormonal, pharmacological and dietary factors. It is believed that the blend of those factors triggers the physiopathological process, with inflammation as the primary event and the fibroblast activity and abnormal collagen synthesis added, generating the scarring process and possible autoimmune sensitization. Diagnosis is generally made clinically, but performing a biopsy is possible in some cases to rule out potential differential diagnosis. Due to the possibility of cancer development in the affected areas and scarring process that conclude in impaired quality of life, a timely and effective treatment is important.