Scleroatrophic lichen in women
DOI: 10.32364/2587-6821-2025-9-6-5
E.V. Dvoryankova1,2, I.V. Kvach2
1Center for Theoretical Problems of Physico-Chemical Pharmacology, Russian Academy of Sciences, Moscow, Russian Federation
2Professor Yutskovskaya Clinic LLC, Moscow, Russian Federation
Anogenital itch and clinical manifestations such as erythema, maceration, cracks, white spots on the skin and mucous membrane of the external genitalia in women may reflect suspected scleroatrophic lichen (SAL). SAL is a chronic inflammatory, non-communicable autoimmune skin disease whose clinical manifestations are atrophic foci that are typically reported in the anogenital region. Despite the disease is quite common, its diagnosis and treatment still present a specific challenge for a medical practitioner. The paper discusses clinical presentation, diagnosis and treatment of SAL. The diagnosis should be confirmed by histological examination of specimens taken from the skin lesions. A dermatologist and a gynecologist should be involved in management of SAL . At the same time, very potent topical glucocorticosteroids (e. g., clobetasol propionate) are the first-line drugs. They are combined with topical calcineurin inhibitors, as well as systemic steroid therapy and methotrexate (if indicated). Timely diagnosis and treatment significantly improve quality of life and prevent complications in the patients. The authors present their own clinical clinical case reports in females with SAL.
Keywords: scleroatrophic lichen, topical glucocorticosteroids, clobetasol propionate, clinical case, anogenital itching.
For citation: Dvoryankova E.V., Kvach I.V. Scleroatrophic lichen in women. Russian Medical Inquiry. 2025;9(6):327–332 (in Russ.). DOI: 10.32364/2587-6821-2025-9-6-5
About the authors:
Evgeniya V. Dvoryankova — Dr. Sc. (Med.), Chief Scientific Officer at the Laboratory of Physico-Chemical and Genetic Issues of Dermatology, Center for Theoretical Problems of Physico-Chemical Pharmacology, Russian Academy of Sciences; 30, Srednyaya Kalitnikovskaya str., Moscow, 109029, Russian Federation; Dermatologist, Professor Yutskovskaya Clinic LLC; bld. 26, room. 8N/2, 102, Mira ave., Moscow, 129626, Russian Federation; ORCID iD 0000-0002-2458-419X
Irina V. Kvach — Gynecologist, Professor Yutskovskaya Clinic LLC; bld. 26, room. 8N/2, 102, Mira ave., Moscow, 129626, Russian Federation; ORCID iD 0009-0009-6968-0327
Contact information: Evgeniya V. Dvoryankova, e-mail: edvoriankova@gmail.com
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 31.03.2025.
Revised 23.04.2025.
Accepted 22.05.2025.
2. Klaber R. Lichen Sclerosus et Atrophicans (Hallopeau). Proc R Soc Med actions. 1937;30(8):977–979. DOI: 10.1177/003591573703000823
3. Lynch P.J., Moyal-Barracco M., Moyal-Barrocco M. et al. 2006 ISSVD classification of vulvar dermatoses: pathologic subsets and their clinical correlates. J Reprod Med. 2007;52:3–9. PMID: 17286059
4. Goldstein A.T., Marinoff S.C., Christopher K., Srodon M. Prevalence of vulvar lichen sclerosus in a general gynecology practice. J Reprod Med. 2005;50:477–480. PMID: 16130842
5. Leibovitz A., Kaplun V., Saposhnicov N., Habot B. Vulvovaginal examinations in elderly nursing home women residents. Arch Gerontol Geriatr. 2000;31:1–4. DOI: 10.1016/s0167-4943(00)00059-5
6. Lee A., Bradford J., Fischer G. Long-term Management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women. JAMA Dermatol. 2015;151:1061–1067. DOI: 10.1001/jamadermatol.2015.0643
7. Vieira-Baptista P., Lima-Silva J., Cavaco-Gomes J. et al. What differentiates symptomatic from asymptomatic women with lichen sclerosus? Gynecol Obstet Invest. 2015;79:263–268. DOI: 10.1159/000367788
8. Oyama N., Chan I., Neill S.M. et al. Development of antigen-specific ELISA for circulating autoantibodies to extracellular matrix protein 1 in lichen sclerosus. J Clin Invest. 2004;113:1550–1559. DOI: 10.1172/JCI20373
9. Howard A., Dean D., Cooper S. et al. Circulating basement membrane zone antibodies are found in lichen sclerosus of the vulva. Australas J Dermatol. 2004;45:12–15. DOI: 10.1111/j.1440-0960.2004.00026.x
10. Kreuter A., Kryvosheyeva Y., Terras S. et al. Association of autoimmune diseases with lichen sclerosus in 532 male and female patients. Acta Derm Venerol. 2013;93:238–241. DOI: 10.2340/00015555-1512
11. Gao X.-H., Barnardo M.C., Winsey S. et al. The association between HLA DR, DQ antigens, and vulval lichen sclerosus in the UK: HLA DRB112 and its associated DRB112/DQB10301/04/09/010 haplotype confers susceptibility to vulval lichen sclerosus, and HLA DRB10301/04 and its associated DRB10301/04/DQB10201/02/03 haplotype protects from vulval lichen sclerosus. J Invest Dermatol. 2005;125:895–899. DOI: 10.1111/j.0022-202X.2005.23905.x
12. Carlson J.A., Murphy M. Androgen receptors and lichen sclerosus. J Am Acad Dermatol. 2000;43:559–560. DOI: 10.1067/mjd.2000.109276
13. Edwards L., Lynch P.J., Genital Dermatology Atlas. Philadelphia, PA: Lippincott Williams & Wilkins; 2011.
14. Regauer S., Liegl B., Reich O. Early vulvar lichen sclerosus: a histopathological challenge. Histopathology. 2005;47:340–340. DOI: 10.1111/j.1365-2559.2005.02209.x
15. Van De Nieuwenhof H.P., Meeuwis K.A.P., Nieboer T.E. et al. The effect of vulvar lichen sclerosus on quality of life and sexual functioning. J Psychosom Obstet Gynaecol. 2010;31:279–284. DOI: 10.3109/0167482X.2010.507890
16. Haefner H.K., Aldrich N.Z., Dalton V.K. et al. The impact of vulvar lichen sclerosus on sexual dysfunction. J Womens Health (Larchmt). 2014;23:765–770. DOI: 10.1089/jwh.2014.4805
17. Halonen P., Jakobsson M., Heikinheimo O. et al. Lichen sclerosus and risk of cancer. Int J Cancer. 2017;140:1998–2002. DOI: 10.1002/ijc.30621
18. Kirtschig G., Becker K., Günther A. et al. Evidence-based (S3) Guideline on (anogenital) Lichen sclerosus. Eur Acad Dermatol Venereol. 2015;29(10):e1–43. DOI: 10.1111/jdv.13136
19. Boms S., Gambichler T., Freitag M. et al. Pimecrolimus 1% cream for anogenital lichen sclerosus in childhood. BMC Dermatol. 2004;4:14. DOI: 10.1186/1471-5945-4-14
20. Доброхотова Ю.Э., Азимова А.Ю., Боровкова Е.И. и др. Применение неодимового лазера в лечении дистрофических заболеваний вульвы. РМЖ. Мать и дитя. 2023;6(2):138–144. DOI: 10.32364/2618-8430-2023-6-2-138-144Dobrokhotova Yu.E., Azimova A.Yu., Borovkova E.I. et al. The use of neodymium laser in the treatment of vulval dystrophies. Russian Journal of Woman and Child Health. 2023;6(2):138–144 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-138-144
21. Bunker C.B. Comments on the British Association of Dermatologists guidelines for the management of lichen sclerosus. Br J Dermatol. 2011;164:894–895. DOI: 10.1111/j.1365-2133.2010.10183.x
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