EMAS clinical guide: Vulvar lichen sclerosus in peri and postmenopausal women
| Autor: | Yvonne T. van der Schouw, Karin Schenck-Gustafsson, Margaret Rees, Irene Lambrinoudaki, Florence Tremollieres, Iuliana Ceausu, Herman Depypere, Faustino R. Pérez-López, Tommaso Simoncini, C. Tamer Erel |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Calcineurin Inhibitors Disease Lichen sclerosus Tacrolimus Vulvar Lichen Sclerosus General Biochemistry Genetics and Molecular Biology Pimecrolimus Adrenal Cortex Hormones Humans Medicine Intraepithelial neoplasia business.industry Obstetrics and Gynecology medicine.disease Dermatology Perimenopause Postmenopause Early Diagnosis Etiology Dermal atrophy Female Vulvar Diseases Clobetasol propionate business Precancerous Conditions medicine.drug |
| Zdroj: | Maturitas. 74:279-282 |
| ISSN: | 0378-5122 |
| Popis: | Introduction Vulvar lichen sclerosus (LS) is a chronic inflammatory disease which affects genital labial, perineal and perianal areas, producing significant discomfort and psychological distress. However there may be diagnostic delay because of late presentation and lack of recognition of symptoms. Aims The purpose of this clinical guide is to provide advice on early recognition and treatment. Material and methods Literature review and consensus of expert opinion. Results and conclusions The etiology of LS in peri and postmenopausal women is unknown, although autoimmune, genetic and infectious factors have been implicated. Definitive diagnosis of non-malignant disorders depends on the histology of biopsied tissue. LS associated with cellular atypia should be classified as intraepithelial neoplasia. Topical corticosteroids are the most effective treatment, although prolonged treatment may be associated with dermal atrophy. Topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, may be a safe and effective alternative treatment without risk of corticosteroid-related vulvar atrophy since they do not affect collagen synthesis. LS recurrences are frequent, and can lead to significant physical discomfort and emotional distress that affect mood and sexual relationships. Anatomical changes may require surgical management. |
| Databáze: | OpenAIRE |
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