Clinical and morphological stages vulvar lichen sclerosus

Abstract

Aim. To determine leading clinical symptoms and risk factors for vulvar lichen sclerosus, identify the features of the disease in the early and late stages. Materials and methods. The investigation included 102 patients with clinical symptoms of aged 21 to 79 (the average age was 50.613.9 years), 67/102 (66%) conducted punch biopsy of vulva. The control group consisted of 113 women without signs of vulvar lichen sclerosus according to clinical and anamnestic examination. Results and discussion. Patients with VLS are overweight and obese 1 degree (BMI26.5), have a low level of physical activity and sleep durations 6.6 hours, experience stress and have low resistance to stress factors. Among gynecological diseases, patients with VLS are more often diagnosed with uterine myoma (42%) and genital endometriosis (29%). Among extragenital diseases, endocrine (54%), autoimmune (53%), diseases of the urinary system (54%) and skin (14%), benign diseases of the mammary glands (28.57%) prevail. Scars and deformations of the perineum, as a risk factor for VLS, are observed in 46.21%; 5% of women have a family history of VLS. Conclusion. Vulvar lichen sclerosus is a multifactorial disease, divided into early and late stages. Subjective symptoms of VLS are not related to age, duration and stage of the disease. Mucosal edema is characteristic of the early stage, and the late stage is characterized by a change in the architectonics of the external genitalia. In 11% of cases, the disease has no visual changes on the vulva. In this case, the most exact diagnostic method for VLS is a histological examination, which allows doctors to establish a diagnosis even at an early stage.