title: The management of lichen sclerosus in a genitourinary medicine setting: a 12-month retrospective case-notes review.
abstract: A retrospective case-notes review was undertaken of all women with lichen sclerosus seen during a 12-month period to review their characteristics and care. A total of 273 case-notes were reviewed. The mean age was 61 years (range, 14-94), and the mean duration of symptoms was 6.4 years (range, 1-50). The mean age at diagnosis was 55 years (range, 7-92). Sixty-two (23%) had at least one other autoimmune condition. Autoimmune conditions were seven times more frequent overall compared with United Kingdom prevalences. On-going symptoms were reported as none/minimal in 196 (72%), moderate in 65 (24%) and severe in 12 (4%). A total of 233 women (85%) had on-going treatment with clobetasol propionate (Dermovate) ointment with a mode of eight applications per month (range, 0-30). Forty-three women (16%) reported sexual dysfunction and 13 (5%) had needed at least one surgical procedure to restore sexual function. Eighty-six (32%) had undergone at least one biopsy. Nine squamous cell cancers (3%) had been diagnosed in six women (2%). These patients were managed in line with all current guidance. It is surprising that there is still no evidence to direct long-term management.
authors.affiliation: GUM Department, Derriford Hospital, Plymouth, UK rachel@challenor.biz.
authors.forename: Rachel
authors.initials: R
authors.lastname: Challenor
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002990:Clobetasol / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D019468:Disease Management; D005260:Female; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom; D014845:Vulvar Diseases / Q000188:drug therapy
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D002990:Clobetasol
keywords: Lichen sclerosus; autoimmune; case-notes review; sexual health; vulval cancer; women