Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review

Table 2

Clinical features of vulvar lichen sclerosus.

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Signs and symptoms

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 Asymptomatic

 Chronic pruritus

 Dyspareunia or apareunia

 Anorgasmia

 Dysuria

 Genital bleeding

 Constipation

 Painful defecation

 Pale lesion with atrophic changes in vulva

 Loss of labia minora

 Burying of the clitoris

 Obstruction of urinary flow

 Reduction of the vaginal introitus

 Fourchette adhesions

 Subepithelial hemorrhage due to pruritis

 Classic “figure of eight” shape of the lesion

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Comorbidities

 Morphea or localized scleroderma

 Systemic sclerosis

 Hashimoto’s thyroiditis

 Rheumatoid arthritis

 Psoriasis

 Diabetes mellitus type 1

 Alopecia areata

 Overactive bladder

 Stress urinary incontinence

 Irritable bowel syndrome

 Fibromyalgia

 Temporomandibular joint disorder

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Associated Malignancy

 Neoplastic transformation to squamous cell carcinoma

 Association with melanoma reported

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Pschosexual Impact

 Concerns of loss of relationships

 Desires to regain intimacy and sexual enjoyment

 Negative influence on female genital self-image

 Negative correlation with sexual arousal, orgasm, and satisfaction rates

 Less frequent sexual activity

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