EuroGuiderm guideline on lichen sclerosus-introduction into lichen sclerosus

Kirtschig, G. and Kinberger, M. and Kreuter, A. and Simpson, R. and Gunthert, A. and van Hees, C. and Becker, K. and Ramakers, M. J. and Corazza, M. and Mueller, S. and von Seitzberg, S. and Boffa, M. J. and Stein, R. and Barbagli, G. and Chi, C. C. and Dauendorffer, J. N. and Fischer, B. and Gaskins, M. and Hiltunen-Back, E. and Hofinger, A. and Kollmann, N. H. and Kuehn, H. and Larsen, H. K. and Lazzeri, M. and Mendling, W. and Nikkels, A. F. and Promm, Martin and Rall, K. K. and Regauer, S. and Sardy, M. and Sepp, N. and Thune, T. and Tsiogka, A. and Vassileva, S. and Voswinkel, L. and Woelber, L. and Werner, R. N. (2024) EuroGuiderm guideline on lichen sclerosus-introduction into lichen sclerosus. JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 38 (10). pp. 1850-1873. ISSN 0926-9959, 1468-3083

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Abstract

IntroductionLichen sclerosus (LS) is an inflammatory skin disease affecting all ages. LS typically involves the anogenital site where it causes itching and soreness. It may lead to sexual and urinary dysfunction in females and males; however, it may be asymptomatic. First signs of LS are redness and oedema, typically followed by whitening of the genital skin; sometimes fissuring, scarring, shrinkage and fusion of structures may follow in its course. LS is associated with an increased risk of genital cancer. LS has a huge impact on the quality of life of affected patients, and it is important to raise more awareness of this not uncommon disease in order to diagnose and treat it early.ObjectivesThe guideline intends to provide guidance on the diagnostic of LS, highlight important aspects in the care of LS patients (part 1), generate recommendations and treatment algorithms (part 2) on topical, interventional and surgical therapy, based on the latest evidence, provide guidance in the management of LS patients during pregnancy, provide guidance for the follow-up of patients with LS and inform about new developments and potential research aspects.Materials and MethodsThe guideline was developed in accordance with the EuroGuiDerm Methods Manual v1.3 . The wording of the recommendations was standardized (as suggested by the GRADE Working Group). The guideline development group is comprised of 34 experts from 16 countries, including 5 patient representatives.ResultsUltrapotent or potent topical corticosteroids in females and males, adults and children remain gold standard of care for genital LS; co-treatment with emollients is recommended. If standard treatment fails in males, a surgical intervention is recommended, complete circumcision may cure LS in males. UV light treatment is recommended for extragenital LS; however, there is limited scientific evidence. Topical calcineurin inhibitors are second line treatment. Laser treatment, using various wave lengths, is under investigation, and it can currently not be recommended for the treatment of LS. Treatment with biologics is only reported in single cases.ConclusionsLS has to be diagnosed and treated as early as possible in order to minimize sequelae like scarring and cancer development. Topical potent and ultrapotent corticosteroids are the gold standard of care; genital LS is often a lifelong disease and needs to be treated long-term.

Item Type: Article
Uncontrolled Keywords: BORRELIA-BURGDORFERI INFECTION; ACRODERMATITIS CHRONICA ATROPHICANS; EXTRACELLULAR-MATRIX PROTEIN-1; BALANITIS XEROTICA OBLITERANS; POLYMERASE-CHAIN-REACTION; QUALITY-OF-LIFE; ET-ATROPHICUS; BURIED PENIS; RISK-FACTORS; FOLLOW-UP;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Urologie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 06 Aug 2025 06:46
Last Modified: 06 Aug 2025 06:46
URI: https://pred.uni-regensburg.de/id/eprint/65680

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