LICHEN SCLEROSUS – EPIDEMIOLOGY, TREATMENT, IMPACT ON QUALITY OF LIFE AND EMERGING THERAPEUTIC APPROACHES - A REVIEW
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5556Keywords:
Lichen Sclerosus, LS, Diagnosis, Treatment, Quality of Life, Anogenital Skin LesionsAbstract
Lichen sclerosus (LS) is a chronic, inflammatory skin disease with a complex, multifactorial etiology, encompassing immunological, genetic, hormonal, and environmental factors. The disease most commonly affects the anogenital region, leading to characteristic porcelain-white, atrophic plaques that can cause anatomical deformities, scarring, and impairments in sexual and urological function. LS symptoms are variable and include pruritus, pain, dyspareunia, urinary and bowel disturbances, as well as extragenital lesions in keratotic, bullous, or annular forms. The prevalence of LS differs between children and adults, and diagnostic delays can range from several months up to five years, increasing the risk of complications, including squamous cell carcinoma of the genital organs.
Diagnosis is primarily based on clinical examination, dermoscopy, and, in ambiguous cases, skin biopsy. Standard treatment includes topical glucocorticosteroids, with the possibility of maintenance therapy and adjunctive approaches such as calcineurin inhibitors, laser therapies, or systemic acitretin. Due to the chronic course of the disease and its impact on quality of life, patient care should be multidisciplinary, incorporating psychological support, sexual counseling and patient education.
The aim of this study is to provide a comprehensive overview of the clinical manifestations, diagnostic methods, therapeutic strategies, and consequences of LS for patient functioning. Emphasizing the importance of early diagnosis, monitoring of lesions, and patient education may contribute to improved treatment outcomes and quality of life for affected individuals.
References
Ankad, B. S., & Beergouder, S. L. (2015). Dermoscopic patterns in lichen sclerosus: A report of three cases. Indian Dermatology Online Journal, 6(3), 237–240. https://doi.org/10.4103/2229-5178.156450
Arif, T., Fatima, R., & Sami, M. (2022). Extragenital lichen sclerosus: A comprehensive review. Australasian Journal of Dermatology, 63(4), 452–462. https://doi.org/10.1111/ajd.13890
Chamli, A., & Souissi, A. (2023). Lichen sclerosus. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538246/
Conte, S., Mohamed, S. D., Cohen, Y., Yacovelli, A., Starkey, S., Johnston, L., Shergill, M., Law, A., Litvinov, I. V., & Mukovozov, I. (2025). Clinical presentations and complications of lichen sclerosus: A systematic review. Journal der Deutschen Dermatologischen Gesellschaft, 23(2), 143–149. https://doi.org/10.1111/ddg.15606
De Luca, D. A., Papara, C., Vorobyev, A., Staiger, H., Bieber, K., Thaci, D., & Ludwig, R. J. (2023). Lichen sclerosus: The 2023 update. Frontiers in Medicine, 10, 1106318. https://doi.org/10.3389/fmed.2023.1106318
Errichetti, E., Lallas, A., Apalla, Z., Di Stefani, A., & Stinco, G. (2017). Dermoscopy of morphea and cutaneous lichen sclerosus: Clinicopathological correlation study and comparative analysis. Dermatology, 233(6), 462–470. https://doi.org/10.1159/000484947
Funaro, D., Lovett, A., Leroux, N., & Powell, J. (2014). A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus. Journal of the American Academy of Dermatology, 71(1), 84–91. https://doi.org/10.1016/j.jaad.2014.02.019
Ganesan, L., Parmar, H., Das, J. K., & Gangopadhyay, A. (2015). Extragenital lichen sclerosus et atrophicus. Indian Journal of Dermatology, 60(4), 420. https://doi.org/10.4103/0019-5154.160516
Jabłonowska, O., Woźniacka, A., & Żebrowska, A. (2021). Lichen sclerosus. Dermatology Review/Przegląd Dermatologiczny, 108(2), 126–136. https://doi.org/10.5114/dr.2021.107284
Jerkovic Gulin, S., Liljeberg, L., & Seifert, O. (2024). The impact of genital lichen sclerosus in men and women on quality of life: A prospective cohort study. International Journal of Women’s Dermatology, 10(1), e131. https://doi.org/10.1097/JW9.0000000000000131
Kirtschig, G. (2016). Lichen sclerosus: Presentation, diagnosis and management. Deutsches Ärzteblatt International, 113(19), 337–343. https://doi.org/10.3238/arztebl.2016.0337
Krapf, J. M., Mitchell, L., Holton, M. A., & Goldstein, A. T. (2020). Vulvar lichen sclerosus: Current perspectives. International Journal of Women’s Health, 12, 11–20. https://doi.org/10.2147/IJWH.S191200
Kraus, C. N. (2022). Vulvar lichen sclerosus. JAMA Dermatology, 158(9), 1088. https://doi.org/10.1001/jamadermatol.2022.0359
Kumar, K. S., Morrel, B., van Hees, C. L. M., van der Toorn, F., van Dorp, W., & Mendels, E. J. (2022). Comparison of lichen sclerosus in boys and girls: A systematic literature review of epidemiology, symptoms, genetic background, risk factors, treatment, and prognosis. Pediatric Dermatology, 39(3), 400–408. https://doi.org/10.1111/pde.14967
Kwok, M., Shugg, N., Siriwardana, A., Calopedos, R., Richards, K., Bandi, S., Hempenstall, J., Rashid, P., & Desai, D. (2022). Prevalence and sequelae of penile lichen sclerosus in males presenting for circumcision in regional Australia: A multicentre retrospective cohort study. Translational Andrology and Urology, 11(6), 780–785. https://doi.org/10.21037/tau-22-29
Mahajan, S. A., & Dave, J. S. (2022). Dermoscopic evaluation of extragenital lichen sclerosus et atrophicus. Dermatology Practical & Conceptual, 12(3), Article 1203a125. https://doi.org/10.5826/dpc.1203a125
Marfatia, Y., Surani, A., & Baxi, R. (2019). Genital lichen sclerosus et atrophicus in females: An update. Indian Journal of Sexually Transmitted Diseases and AIDS, 40(1), 6–12. https://doi.org/10.4103/ijstd.IJSTD_23_19
Melnick, L. E., Steuer, A. B., Bieber, A. K., Wong, P. W., & Pomeranz, M. K. (2020). Lichen sclerosus among women in the United States. International Journal of Women’s Dermatology, 6(4), 260–262. https://doi.org/10.1016/j.ijwd.2020.05.001
Nair, P. A. (2017). Vulvar lichen sclerosus et atrophicus. Journal of Mid-Life Health, 8(2), 55–62. https://doi.org/10.4103/jmh.JMH_13_17
Oyama, N., & Hasegawa, M. (2022). Lichen sclerosus: A current landscape of autoimmune and genetic interplay. Diagnostics, 12(12), 3070. https://doi.org/10.3390/diagnostics12123070
Singh, N., Mishra, N., & Ghatage, P. (2021). Treatment options in vulvar lichen sclerosus: A scoping review. Cureus, 13(2), e13527. https://doi.org/10.7759/cureus.13527
Steben, M. (2022). Lichen sclerosus: Why do most women struggle with their diagnosis? Journal of Obstetrics and Gynaecology Canada, 44(2), 119–120. https://doi.org/10.1016/j.jogc.2021.12.001
Tasker, G. L., & Wojnarowska, F. (2003). Lichen sclerosus. Clinical and Experimental Dermatology, 28(2), 128–133. https://doi.org/10.1046/j.1365-2230.2003.01211.x
Tran, D. A., Tan, X., Macri, C. J., Goldstein, A. T., & Fu, S. W. (2019). Lichen sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets. International Journal of Biological Sciences, 15(7), 1429–1439. https://doi.org/10.7150/ijbs.34613
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Martyna Kadłubańska, Aleksandra Anna Kuls, Sonia Zembrzuska , Nicole Bulińska, Bogusław Pabis, Zofia Sinczak, Aleksandra Zofia Sobol, Justyna Maria Wiktorowicz, Stanisław Bajerski , Anna Maria Kowalska

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.

