Lichen sclerosus among women in the United States

Laura E Melnick, Alexa B Steuer, Amy Kalowitz Bieber, Priscilla W Wong, Miriam Keltz Pomeranz, Laura E Melnick, Alexa B Steuer, Amy Kalowitz Bieber, Priscilla W Wong, Miriam Keltz Pomeranz

Abstract

Background: Vulvar lichen sclerosus (LS) is a chronic dermatosis for which the true prevalence is not well established. LS remains an underrecognized and undertreated disease, and treatment patterns and differences among various specialties that care for patients with LS are largely unknown.

Objective: This study sought to determine the prevalence of diagnosed vulvar LS, demographic characteristics, and diagnostic and treatment patterns in the United States.

Methods: A database comprising >21.7 million women with commercial insurance in the United States was analyzed, and the largest cohort of patients with LS in the United States to date was identified.

Results: We found that obstetricians/gynecologists are diagnosing and managing approximately half of women with LS, and regardless of specialty, the majority of providers are appropriately prescribing high-potency topical steroids.

Conclusion: Our results suggest that LS may truly be underrecognized and underdiagnosed, especially in younger women.

Keywords: Lichen sclerosus; Prevalence; Treatment; Vulvar lichen sclerosus.

© 2020 Published by Elsevier Inc. on behalf of Women's Dermatologic Society.

Figures

Fig. 1
Fig. 1
Treatments prescribed by top five specialties/types of providers treating lichen sclerosus.

References

    1. Cooper S.M., Ali I., Baldo M., Wojnarowska F. The association of lichen sclerosus and erosive lichen planus of the vulva with autoimmune disease: a case-control study. Arch Dermatol. 2008;144(11):1432–1435.
    1. Fistarol S.K., Itin P.H. Diagnosis and treatment of lichen sclerosus: an update. Am J Clin Dermatol. 2013;14(1):27–47.
    1. Goldstein A.T., Marinoff S.C., Christopher K., Srodon M. Prevalence of vulvar lichen sclerosus in a general gynecology practice. J Reprod Med. 2005;50(7):477–480.
    1. Lagerstedt M., Karvinen K., Joki-Erkkila M., Huotari-Orava R., Snellman E., Laasanen S.L. Childhood lichen sclerosus–a challenge for clinicians. Pediatr Dermatol. 2013;30(4):444–450.
    1. Pugliese J.M., Morey A.F., Peterson A.C. Lichen sclerosus: review of the literature and current recommendations for management. J Urol. 2007;178(6):2268–2276.
    1. Schlosser B.J., Mirowski G.W. Lichen sclerosus and lichen planus in women and girls. Clin Obstet Gynecol. 2015;58(1):125–142.
    1. Trokoudes D., Lewis F.M. Lichen sclerosus - the course during pregnancy and effect on delivery. J Eur Acad Dermatol Venereol. 2019;33(12):e466–e468.
    1. Yang M., Wen W., Chang J. Vulvar lichen sclerosus: a single-center retrospective study in China. J Dermatol. 2018;45(9):1101–1104.

Source: PubMed

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