Prevalence of vulvar lichen sclerosus in a general gynecology practice.
OBJECTIVE
To describe the rate of vulvar lichen sclerosus in 1 general gynecology practice.


METHODS
A database of 1,675 consecutive patients presenting in a 3-year period to a general gynecology practice was utilized to identify women with lichen sclerosus. Data included age, menopausal status, symptoms and physical examination findings. Pathology specimens were reexamined by a gynecologic pathologist to confirm the diagnosis of lichen sclerosus.


RESULTS
Of the 1,675 patients, 28 (1.7%) had biopsy-proven vulvar lichen sclerosus. Nine patients been diagnosed previously, and 19 were new cases. The mean age at diagnosis was 52.6 years (SD +/- 15.9) versus 37.1 years (SD +/- 16.4) for those without lichen sclerosus (p < 0.001). Fifteen of the 28 patients (54%) were post-menopausal at the time of diagnosis. Of the 19 women with newly diagnosed lichen sclerosus, 8 (42%) were symptomatic. Of the 11 asymptomatic women, 7 (64%) had scarring of the clitoral prepuce or resorption of the labia minora.


CONCLUSIONS
The rate of vulvar lichen sclerosus in 1 general gynecology private practice is approximately 1.7%. Clinicians must maintain a high index of suspicion to make the diagnosis, as at least one third of patients may be asymptomatic.
Goldstein
Andrew T
AT
Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA. obstetrics@yahoo.com
Marinoff
Stanley C
SC
Christopher
Kurt
K
Srodon
Monica
M
D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D010808:Physical Examination; D015995:Prevalence; D012189:Retrospective Studies; D007724:Vulvar Lichen Sclerosus / Q000453:epidemiology* / Q000473:pathology