Lichen sclerosus – insights from a dermatologist and therapeutic approaches

Česká verze

Authors: T. Rajcigelová ; A. Gajdošová; Z. Žingorová; T. Neplechová; J. Péč; K. Vorčáková
Authors place of work: Dermatovenerologická klinika JLF UK a UN Martin, Slovenská republika
Published in the journal: Ceska Gynekol 2026; 91(3): 206-210
Category: Přehledová práce
doi: https://doi.org/10.48095/cccg2026206

Summary

Lichen sclerosus is a cutaneous disorder affecting the external genitalia, with diagnosis and treatment generally managed by a dermatovenerologist. However, in clinical practice, gynecologists are frequently the first physicians to encounter affected patients. Lichen sclerosus is characterized as chronic, lymphocyte-mediated inflammatory dermatosis that requires a multidisciplinary approach. The incomplete understanding of its etiopathogenesis is reflected in limited therapeutic options, which are primarily directed toward stabilization of clinical manifestations, symptom control, reduction of complications associated with chronic inflammation, and prevention of malignant transformation. This article reviews current conventional therapeutic strategies, discusses alternative approaches in the management of lichen sclerosus and additional recommendations applicable in gynecological practice.

Keywords:

Pathogenesis – therapy – lichen sclerosus

Zdroje

1. Hallopeau H. Lecons cliniques sur les maladies cutanées et syphilitiques. Union Med Can 1887; 43 : 472.

2. Alyousef S, Alqahtani L, Shadid A et al. Medication‐induced lichen sclerosus: a systematic review. Dermatol Rev 2025; 6 (2): e70031. doi: 10.1002/der2.70031.

3. Lee A, Fischer G. Diagnosis and teatment of vulvar lichen sclerosus: an update for dermatologists. Am J Clin Dermatol 2018; 19 (5): 695–706. doi: 10.1007/s40257-018-0364-7.

4. Tan X, Ren S, Yang C et al. Differentially regulated miRNAs and their related molecular pathways in lichen sclerosus. Cells 2021; 10 (9): 2291. doi: 10.3390/cells10092291.

5. Papini M, Russo A, Simonetti O et al. Mucous membrane disorders research group of SIDeMaST. Diagnosis and management of cutaneous and anogenital lichen sclerosus: recommendations from the Italian Society of Dermatology (SIDeMaST). Ital J Dermatol Venerol 2021; 156 (5): 519–533. doi: 10.23736/S2784-8671.21.06764-X.

6. 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 (1): 12–15. doi: 10.1111/j.1440-0960.2004.00026.x.

7. Edmonds EV, Oyama N, Chan I et al. Extracellular matrix protein 1 autoantibodies in male genital lichen sclerosus. Br J Dermatol 2011; 165 (1): 218–219. doi: 10.1111/j.1365-2133.2011.10326.x.

8. Tasleem A, Rafiya F, Marwa S. Extragenital lichen sclerosus: a comprehensive review. Australas J Dermatol 2022; 63 (4): 452–462. doi: 10.1111/ajd.13890.

9. Conteduca V, Medri M, Mazzoni L et al. Anogenital lichen sclerosus et atrophicus lesions in a case series of cancer patients on immunotherapy. Cancer Immunol Immunother 2022; 71 (6): 1545–1548. doi: 10.1007/s00262-021-03094-0.

10. Zollinger T, Mertz KD, Schmid M et al. Borrelia in granuloma annulare, morphea and lichen sclerosus: a PCR-based study and review of the literature. J Cutan Pathol 2010; 37 (5): 571–577. doi. 10.1111/j.1600-0560.2009.01493.x.

11. Ena P, Lorrai P, Pintus A et al. Development of multifocal squamous cell carcinoma in lichen sclerosus et atrophicus of the penis associated to HCV hepatitis. Andrology 2004; 36 (1): 38–40. doi: 10.1046/j.1439-0272.2003.00600.x.

12. Aidé S, Lattario FR, Almedia G et al. Epstein-Barr virus and human papillomavirus infection in vulvar lichen sclerosus. J Low Genit Tract Dis 2010; 14 (4): 319–320. doi: 10.1097/LGT. 0b013e3181d734f1.

13. de Martino M, Haitel A, Wrba F et al. High--risk human papilloma virus infection of the foreskin in asymptomatic boys. Urology 2013; 81 (4): 869–872. doi: 10.1016/j.urology.2012.12.011.

14. Günther AR, Faber M, Knappe G et al. Early onset vulvar Lichen Sclerosus in premenopausal women and oral contraceptives. Eur J Obstet Gynecol Reprod Biol 2008; 137 (1): 56–60. doi: 10.1016/j.ejogrb.2007.10.005.

15. Vik V, Nencka P, Záleský M et al. Lichen sclerosus –⁠ stále přehlížená urologická diagnóza se závažnými komplikacemi. Ces Urology 2011; 15 (2): 78–84. doi: 10.48095/cccu2011015.

16. Promm M, Rösch WH et Kirtschig G. Lichen sclerosus in children. Urologe A 2020; 59 (3): 271–277. doi: 10.1007/s00120-020-01140-w.

17. Sauder MB, Linzon-Smith J, Beecker J. Extragenital bullous lichen sclerosus. J Am Acad Dermatol 2014; 71 (5): 981–984. doi: 10.1016/j.jaad.2014.06.037.

18. Kirtschig G, Kinberger M, Kreuter A et al. EuroGuiderm guideline on lichen sclerosus –⁠ treatment of lichen sclerosus. J Eur Acad Dermatol Venereol 2024; 38 (10): 1874–1909. doi: 10.1111/jdv.20083.

19. Kirtschig G, Becker K, Günthert A et al. Evidence-based (S3) guideline on (anogenital) lichen sclerosus. J Eur Acad Dermatol Venereol 2015; 29 (10): e1–e43. doi: 10.1111/jdv.13136

20. Li J, Zheng W, Tang J et al. Lichen sclerosus successfully treated with baricitinib plus psoralen and ultraviolet A. Dermatol Ther 2021; 34 (3): e14896. doi: 10.1111/dth.14896.

21. Manuelpillai N, Saunders H, Veysey E. Management of severe vulval lichen sclerosus with adalimumab. Australas J Dermatol 2022; 63 (2): 248–250. doi: 10.1111/ajd.13814.

22. Chicharro-Alcántara D, Rubio-Zaragoza M, Damiá-Giménez E et al. Platelet rich plasma: new insights for cutaneous wound healing management. J Funct Biomater 2018; 9 (1): 10. doi: 10.3390/jfb9010010.

23. Nayeemuddin F, Yates VM. Lichen sclerosus et atrophicus responding to methotrexate. Clin Exp Dermatol 2008; 33 (5): 651–652. doi: 10.1111/j.1365-2230.2008.02721.x.

24. Neill SM, Lewis FM, Tatnall FM et al. British Association of Dermatologists’ guidelines for the management of lichen sclerosus 2010. Br J Dermatol 2010; 163 (4): 672–682. doi: 10.1111/j.1365-2133.2010.09997.x.