title: What differentiates symptomatic from asymptomatic women with lichen sclerosus?
abstract: OBJECTIVE
  To investigate the differences between symptomatic and asymptomatic women with vulvar lichen sclerosus (LS).
  
  
  METHODS
  Data on file concerning 228 LS patients was retrospectively reviewed.
  
  
  RESULTS
  Most patients were symptomatic (193/228; 85%). Worsening of symptoms related to specific food intake was experienced by 26% (48/182) and pork was the most frequently cited (25/48; 52%); worsening at night was reported by 47% (87/185). Being over 50 years at the time of diagnosis or being menopausal were associated with being symptomatic (RR = 2.47, 95% CI: 1.15-5.29 and 6.55, 2.05-20.91, respectively). The same was true for urinary incontinence (UI) (5.23, 1.78-15.42), the use of absorbents (without UI) (3.59, 1.05-12.34) and dyspareunia (5.28, 1.64-17.0). All patients with a family history of LS were symptomatic. There was no association with hormonal factors or specific vulvar anatomical changes.
  
  
  CONCLUSIONS
  Pork consumption may be involved in the worsening of symptoms. UI and the use of absorbents are more commonly present in symptomatic LS patients. Dietary changes and correction of UI might be useful in the control of LS symptoms. © 2015 S. Karger AG, Basel.
authors.affiliation: Serviço de Ginecologia e Obstetrícia, Clínica da Mulher, Hospital de São João, Porto, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Vieira-Baptista
authors.forename: Joana
authors.initials: J
authors.lastname: Lima-Silva
authors.forename: João
authors.initials: J
authors.lastname: Cavaco-Gomes
authors.forename: Jorge
authors.initials: J
authors.lastname: Beires
authors.forename: José
authors.initials: J
authors.lastname: Martinez-de-Oliveira
mesh_terms: D041342:Absorbent Pads / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004414:Dyspareunia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D000069466:Red Meat / Q000009:adverse effects*; D014549:Urinary Incontinence / Q000453:epidemiology*; D007724:Vulvar Lichen Sclerosus / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology