Understanding lichen sclerosus: pathogenesis and treatment

Lichen sclerosus is a chronic inflammatory autoimmune skin disease that primarily affects the genital area, especially the vulva. It predominantly affects women and shows a bimodal incidence distribution. The principal clinical manifestations include vulvar itching, pain, and depigmentation, potentially leading to scarring, anatomical distortion, and malignant transformation if left untreated. The etiology is uncertain but may involve autoimmune factors, genetics, infections, hormones, trauma, chronic irritation, and oxidative stress. The diagnosis is primarily clinical, and histological confirmation is not always necessary when characteristic clinical signs are present. Although lichen sclerosus is incurable, it is manageable with appropriate treatment. This review summarizes the epidemiology, clinical features, complications, etiology, diagnosis, and treatment of lichen sclerosus.