Vulvar lichen sclerosus

Vulvar Lichen planus (LS) is a potentially debilitating and chronically relapsing disease that may lead to destructive scarring, impairment in sexual function, and the potential for malignant transformation. A solid knowledge of this disease is essential to ensuring proper diagnosis and treatment. This chapter provides a clinical review of vulvar LS, focusing on diagnosis, treatment options, and clinical follow-up. The exact pathogenesis of LS is unclear, with potential factors including genetic predisposition, autoimmune disorder, local immune response, sex hormone factors, and specific infections. The most frequent autoimmune diseases associated with LS include autoimmune thyroiditis, alopecia areata, vitiligo, pernicious anemia, and LS. Vulvar LS most commonly affects the medial labia majora, interlabial creases, labia minora, clitoral hood, clitoris, and posterior fourchette. Vulvar LS was treated with topical hormone preparations based upon the observation that the highest prevalence of LS occurs in physiological estrogen-deprived states.