title: Lichen sclerosus: treatment and follow-up at the departments of gynaecology and dermatology.
abstract: OBJECTIVE
  To compare the treatment and follow-up of patients with lichen sclerosus (LS) at the departments of Gynaecology and Dermatology at the Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, to evaluate the need for a multidisciplinary vulvar clinic.
  
  
  METHODS
  Treatment and follow-up data of all women with histologically proven (between January 1995 and January 2001) anogenital LS visiting the outpatient clinics of the departments of Obstetrics & Gynaecology and Dermatology were collected (last date of follow-up: January 2008).
  
  
  RESULTS
  Eighty-four patients with LS were included in this study, 10 patients (12%) of which were treated by both specialties. At the Gynaecology department, LS patients more often received surgical treatment, topical estrogens, and lidocaine ointment, whereas at the Dermatology department, local class 2/3 corticosteroids were more often prescribed. Follow-up frequencies were similar in both specialties and took place at 3 to 4 visits in the first year and at least once a year afterward. One patient developed vulvar squamous cell carcinoma. This patient had withdrawn from follow-up and had her condition diagnosed with carcinoma 74 months after the LS had been diagnosed.
  
  
  CONCLUSIONS
  Although no hospital guidelines existed, management of patients with LS agreed with current recommendations in the literature, although differences in secondary and supportive therapy existed owing to differences in expertise. The relatively high percentage of patients treated by both specialties with a high frequency of visits emphasizes the need for a multidisciplinary clinic for vulvar disease.
authors.affiliation: Department of Obstetrics & Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. i.vanderavoort@obgyn.umcn.nl
authors.forename: Irene A M
authors.initials: IA
authors.lastname: van der Avoort
authors.forename: Demia E M
authors.initials: DE
authors.lastname: Tiemes
authors.forename: Michelle M
authors.initials: MM
authors.lastname: van Rossum
authors.forename: Carine J M
authors.initials: CJ
authors.lastname: van der Vleuten
authors.forename: Leon F A G
authors.initials: LF
authors.lastname: Massuger
authors.forename: Joanne A
authors.initials: JA
authors.lastname: de Hullu
mesh_terms: D000046:Academic Medical Centers; D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000188:drug therapy* / Q000601:surgery*; D008012:Lidocaine / Q000008:administration & dosage; D008875:Middle Aged; D009426:Netherlands; D010044:Outpatient Clinics, Hospital; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D004967:Estrogens; D008012:Lidocaine