1. Diagnosis and management of cutaneous and anogenital lichen sclerosus: Recommendations from the Italian Society of Dermatology (SIDemaSt)
- Author
-
Papini, M., Russo, A., Simonetti, O., Borghi, A., Corazza, M., Piaserico, S., Feliciani, C., Calzavara-Pinton, P., Amendolagine, G., Arisi, M., Babino, G., Bardazzi, F., Belloni Fortina, A., Cac-Cavale, S., Campanati, A., Campione, E., Caposiena, C. D., Carugno, A., Coati, I., Cinotti, E., D'Antuono, A., Dattola, A., Dika, E., Fai, D., Fusano, M., Galluzzo, M., Ganzetti, G., Gisondi, P., Hansel, K., Lora, V., Maione, V., Mandel, V. D., Menni, S., Negosanti, M., Neri, I., Offidani, A., Parodi, A., Patrizi, A., Peserico, A., Rossi, M., Rivetti, N., Saccani, E., Stan, T. R., Stingeni, L., Talamonti, M., Vascellaro, A., Vezzoli, P., Virgili, A., Zanca, A., Papini, M., Russo, A., Simonetti, O., Borghi, A., Corazza, M., Piaserico, S., Feliciani, C., Calzavara-Pinton, P., Amendolagine, G., Arisi, M., Babino, G., Bardazzi, F., Belloni Fortina, A., Caccavale, S., Campanati, A., Campione, E., Caposiena, C. D., Carugno, A., Coati, I., Cinotti, E., D'Antuono, A., Dattola, A., Dika, E., Fai, D., Fusano, M., Galluzzo, M., Ganzetti, G., Gisondi, P., Hansel, K., Lora, V., Maione, V., Mandel, V. D., Menni, S., Negosanti, M., Neri, I., Offidani, A., Parodi, A., Patrizi, A., Peserico, A., Rossi, M., Rivetti, N., Saccani, E., Stan, T. R., Stingeni, L., Talamonti, M., Vascellaro, A., Vezzoli, P., Virgili, A., Zanca, A., Papini, M, Russo, A, Simonetti, O, Borghi, A, Corazza, M, Piaserico, S, Feliciani, C, Calzavara-Pinton, P, Amendolagine, G, Arisi, M, Babino, G, Bardazzi, F, Belloni Fortina, A, Cac-Cavale, S, Campanati, A, Campione, E, Caposiena, C, Carugno, A, Coati, I, Cinotti, E, D'Antuono, A, Dattola, A, Dika, E, Fai, D, Fusano, M, Galluzzo, M, Ganzetti, G, Gisondi, P, Hansel, K, Lora, V, Maione, V, Mandel, V, Menni, S, Negosanti, M, Neri, I, Offidani, A, Parodi, A, Patrizi, A, Peserico, A, Rossi, M, Rivetti, N, Saccani, E, Stan, T, Stingeni, L, Talamonti, M, Vascellaro, A, Vezzoli, P, Virgili, A, Zanca, A, Papini M., Russo A., Simonetti O., Borghi A., Corazza M., Piaserico S., Feliciani C., Calzavara-Pinton P., Amendolagine G., Arisi M., Babino G., Bardazzi F., Belloni Fortina A., Cac-Cavale S., Campanati A., Campione E., Caposiena C.D., Carugno A., Coati I., Cinotti E., D'Antuono A., Dattola A., Dika E., Fai D., Fusano M., Galluzzo M., Ganzetti G., Gisondi P., Hansel K., Lora V., Maione V., Mandel V.D., Menni S., Negosanti M., Neri I., Offidani A., Parodi A., Patrizi A., Peserico A., Rossi M., Rivetti N., Saccani E., Stan T.R., Stingeni L., Talamonti M., Vascellaro A., Vezzoli P., Virgili A., and Zanca A.
- Subjects
Male ,medicine.medical_specialty ,Calcineurin Inhibitors ,Socio-culturale ,Disease ,Dermatology ,Lichen sclerosus ,Guideline ,Settore MED/35 ,Lichen sclerosus et atrophicu ,medicine ,Dysuria ,Humans ,Sex organ ,Drug therapy ,Lichen sclerosus et atrophicus ,Operative surgical procedures ,Rare diseases ,Vulvar lichen sclerosus ,Female ,Italy ,Mometasone Furoate ,Lichen Sclerosus et Atrophicus ,Calcineurin Inhibitor ,business.industry ,Mucous membrane ,Evidence-based medicine ,medicine.disease ,Infectious Diseases ,medicine.anatomical_structure ,Sexual dysfunction ,Operative surgical procedure ,Vulvar lichen sclerosu ,medicine.symptom ,business ,Rare disease ,Human - Abstract
Lichen sclerosus (LS) is a disabling chronic inflammatory disease of skin and genital mucous membrane causing itch, pain, dysuria and restriction of micturition, and significant sexual dysfunction and dyspareunia both in women and men. If left untreated, LS is associated with a high degree of sclerosis and scarring, as well as with an elevated risk of cancer in the genital area. Although a central role of autoimmunity is suggested, the pathogenesis of LS is still not clearly understood and the disease remains difficult to treat. The goals of treatment of LS are to alleviate symptoms and discomfort, prevent anatomical changes and prevent malignant transformation. This guideline has been developed by an Italian group of experts. It summarizes evidence-based and expert- based recommendations. The highest level of evidence favors the use of topical high potency corticosteroids; second- and third-line treatments include topical calcineurin inhibitors and topical retinoids, respectively. Surgical treatment has become the treatment of choice in male genital LS with persistent phimosis not responsive to medical treatment. The aim of this paper is to offer evidence-based and easily applicable recommendations for the management of LS.
- Published
- 2021