Quality of Life and Sexual Distress in Women With Erosive Vulvovaginal Lichen Planus

Cheng, Harriet; Oakley, Amanda; Conaglen, John V.; Conaglen, Helen M.

doi:10.1097/lgt.0000000000000282

Cited by 33 publications

(37 citation statements)

References 18 publications

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“…A US study documented high rates of sexual dysfunction in vulvar clinic patients . Another study found that high levels of sexual distress were recorded by 69% of women with LP and 63% of women with lichen sclerosus. In our study, we asked women to consider whether they had active or inactive sexual life, and we found that 64% of all patients declared to be sexually inactive.…”

Section: Discussionmentioning

confidence: 99%

Clinical and epidemiological profile of patients attended in a vulvar clinic of the dermatology outpatient unit of a tertiary hospital during a 4‐year period

et al. 2019

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Background Vulvar complaints are among the most frequent causes for a woman to visit a healthcare provider. The diseases of this area of the body may be a challenge to diagnose. In this study, we assess epidemiologic and clinical data of patients in an outpatient vulvar clinic in the dermatology department of a tertiary hospital. MethodsWe performed an observational retrospective study of patients who attended our consultation service for vulvar diseases at the Dermatology Division at Hospital das Cl ınicas da Faculdade de Medicina da USP during a 4-year period. Data were obtained by patient medical records and by phone.Results During the 4-year period under study, a total of 136 patients were treated in the outpatient service specialized in vulvar care. All patients were included in the study. The most frequent diagnoses were lichen sclerosus et atrophicus (64.7%), lichen planus (8.8%), and vitiligo (8%). We registered that 26.7% of the patients showed extravulvar involvement.Conclusions Women with vulvar diseases need specific care, considering not only genital aspects but also all skin changes. In this context, the dermatologist is a very well trained professional to take good and complete care of these patients. However, ideally vulvar clinics should have a multidisciplinary team.

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Section: Discussionmentioning

confidence: 99%

Clinical and epidemiological profile of patients attended in a vulvar clinic of the dermatology outpatient unit of a tertiary hospital during a 4‐year period

et al. 2019

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“…In our case, although remission of symptoms such as pain and pruritus had occurred, sexual dysfunction was a constant, showing little improvement. Cheng and colleagues [16] demonstrated that 63% of the patients with LS had sexual dysfunction. Quality of life is also extremely affected in this disease.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Lichen Sclerosus and Its Treatments on Sexuality: Case Report

Vettorazzi¹,

Valério²,

Perez³

et al. 2019

OJOG

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Lichen sclerosus is a chronic and autoimmune dermatitis that develops in the anogenital region. It is related to genital alterations with repercussions in sexuality. We present a case of a 60-year-old woman who had several chronic diseases and had been diagnosed with vulvar lichen sclerosus for 20 years, with no response to multiple treatments (topical corticosteroids, immunomodulators). She was submitted to vulvectomy; however, it leads to worsening of her condition, presenting obliterated and fibrosed clitoris, atrophic vaginal lips, and anal and vulvar fissures. She remained with dyspareunia, decreased sexual desire and difficulty in orgasm. She underwent sexual therapy, adjustment of antidepressant medication and made intercalated use of topical corticosteroids, topical testosterone and vaginal moisturizers, with partial improvement. From this case we can conclude that, although vulvectomy can be related to some degree of improvement in patients with lichen sclerosus, serious complications can occur.

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“…In addition, sexual dysfunction has been the chief objective for some investigators. 6,10 However, in our experience a relevant number of patients affected with vulvar inflammatory disorders do not have sexual activity, not only because of disease-related pain or distress. 13 Thus, in many cases tools specifically addressing sexual behaviour may be inadequate for a more comprehensive assessment of the suffering caused by vulvar inflammatory conditions.…”

Section: Introductionmentioning

confidence: 95%

“…The available literature has mainly focused the burden of vulvar LS [4][5][6][7][8][9] and, to a lesser extent, LP. 10 From these studies, it emerged that vulvar LS and LP can negatively affect patients' daily lives and significantly impair their physical and social activities, mental health and intimate relationships. Other vulvar inflammatory conditions have been studied marginally from this point of view.…”

Section: Introductionmentioning

confidence: 99%

Pictorial Representation of Illness and Self‐Measure to assess the perceived burden in patients with chronic inflammatory vulvar diseases: an observational study

Corazza

Virgili

Toni

et al. 2020

Acad Dermatol Venereol

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Background Chronic inflammatory vulvar diseases can have a huge detrimental impact on patient welfare. A few studies have addressed this issue so far, mainly measuring patients' quality of life or sexual dysfunction. Objective To assess the burden of suffering in patients with chronic inflammatory vulvar diseases using the Pictorial Representation of Illness and Self-Measure (PRISM), a visual, non-verbal instrument. We also assessed (i) the concordance between PRISM and the Dermatology Life Quality Index (DLQI), (ii) whether some variables, both patient-related and disease-related, affect the patient's suffering and quality-of-life impairment. Methods We evaluated for inclusion in this cross-sectional study all patients who attended our Vulva Unit over a 9month period with histologically proven lichen sclerosus (LS), lichen planus (LP), lichen simplex chronicus (LSC), eczema, plasma cell vulvitis and psoriasis (at least five for each disease). Demographics and disease-related subjective and objective scores were recorded. The PRISM and DLQI were administered. Results We included 87 patients affected with LS, 13 with LSC and seven with LP. Median PRISM values (0-273 mm) ranged from 95 to 120 mm, depending on the disease, and median DLQI scores (0-30) were five for all three groups. Neither PRISM nor DLQI scores differed significantly among the three groups. Moderate coherence was found between PRISM and DLQI (q = 0.5455, P < 0.001). Global subjective score was the only variable significantly associated with the degree of suffering and quality-of-life impairment. Conclusions Pictorial Representation of Illness and Self-Measure proved to be a valuable, highly reliable tool for measuring the perceived burden in these patients. In spite of a moderate correlation, PRISM resulted more sensitive in capturing patient distress than DLQI.

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Quality of Life and Sexual Distress in Women With Erosive Vulvovaginal Lichen Planus

Abstract: Sixty-nine percent of women with EVLP reported sexual distress. Women with EVLP reported lesser quality of life than those with lichen sclerosus. Quality of life, anxiety and depression, sexual distress, and sexual function were all related in these participants.

Cited by 33 publications

References 18 publications

Clinical and epidemiological profile of patients attended in a vulvar clinic of the dermatology outpatient unit of a tertiary hospital during a 4‐year period

Clinical and epidemiological profile of patients attended in a vulvar clinic of the dermatology outpatient unit of a tertiary hospital during a 4‐year period

The Effects of Lichen Sclerosus and Its Treatments on Sexuality: Case Report

Pictorial Representation of Illness and Self‐Measure to assess the perceived burden in patients with chronic inflammatory vulvar diseases: an observational study

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