title: Clinical review of 202 patients with vulval lichen sclerosus: A possible association with psoriasis.
abstract: Two hundred and two patients with clinically typical or biopsy-confirmed vulval lichen sclerosus were reviewed either at consultation (75%) or by retrospectively examining their chart. At diagnosis, 79% were 50 years or older. Ninety-six per cent complained of itching, pain and/or dyspareunia. Lichen sclerosus most often affected the labia minora and perineum but 50% had perianal and 13% had extragenital disease. Thirty-five patients gave a history of psoriasis (17%), which affected the vulval area in 10. Thyroid disease was reported in 39 patients (19%), and 33 gave a family history of thyroid disease. Of those tested (142), 20% had elevated thyroid antibodies. Topical clobetasol propionate was very effective but at least intermittent treatment was required long term in 85%. At follow up, 101 of 185 patients (56%) were asymptomatic but 22 (12%) continued to have moderate-to-severe symptoms. Thyroid disease and psoriasis are common associated conditions.
authors.affiliation: Health Waikato, Hamilton, New Zealand.
authors.forename: Susan
authors.initials: S
authors.lastname: Simpkin
authors.forename: Amanda
authors.initials: A
authors.lastname: Oakley
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002990:Clobetasol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D018459:Lichen Sclerosus et Atrophicus / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008499:Medical Records; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011565:Psoriasis / Q000150:complications*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014845:Vulvar Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents; D002990:Clobetasol