RESUMEN
BACKGROUND/OBJECTIVES: Vulval lichen sclerosus (VLS) is a chronic inflammatory skin condition predominantly affecting the anogenital region in women and children. To date, there is lack of agreement amongst experts on a severity scale to aid assessment, research and treatment stratification on VLS. Furthermore, literature on best practice for long-term management of VLS is lacking. The aim of this consensus is to provide broad guidelines on the short and long-term management of VLS. METHODS: An initial focus group of Australasian experts in vulval dermatology developed a draft consensus statement for the management of VLS. Based on the results of the draft statement, a consensus panel of 22 Australasian experts, comprised of the initial and additional members, participated in an anonymous four-stage eDelphi process. Round 1 involved generation and voting on statements from the draft consensus statement developed by the focus group. In Rounds 2, 3 & 4, panel members were presented formal feedback from previous rounds and asked to indicate their level of agreement. Consensus was reached if there was ≥70% agreement on the importance of an item in the 4 (agree) to 5 (strongly agree) range. RESULTS: The expert panel, with a total of 504 collective years of experience in the field of VLS, reached consensus on a core set of 51 management statements related to diagnosis, severity, initial and long-term management, follow-up, and complications of VLS. CONCLUSIONS: This study has identified a set of management statements for VLS that may be useful in clinical practice in the Australasian population.
Asunto(s)
Consenso , Liquen Escleroso y Atrófico/terapia , Guías de Práctica Clínica como Asunto/normas , Pautas de la Práctica en Medicina/normas , Liquen Escleroso Vulvar/terapia , Dermatólogos/normas , Femenino , Humanos , Liquen Escleroso y Atrófico/prevención & control , Liquen Escleroso Vulvar/prevención & controlAsunto(s)
Carcinoma de Células Escamosas/prevención & control , Circuncisión Masculina , Enfermedades del Pene/prevención & control , Neoplasias del Pene/prevención & control , Enfermedades de Transmisión Sexual/prevención & control , Adulto , Balanitis/epidemiología , Balanitis/prevención & control , Carcinoma in Situ/epidemiología , Carcinoma in Situ/prevención & control , Carcinoma de Células Escamosas/epidemiología , Niño , Preescolar , Circuncisión Masculina/efectos adversos , Circuncisión Masculina/psicología , Circuncisión Masculina/estadística & datos numéricos , Cultura , Humanos , Recién Nacido , Liquen Escleroso y Atrófico/epidemiología , Liquen Escleroso y Atrófico/prevención & control , Masculino , Enfermedades del Pene/epidemiología , Neoplasias del Pene/epidemiología , Fimosis/cirugía , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Prospectivos , Religión , Enfermedades de Transmisión Sexual/epidemiologíaRESUMEN
Lichen sclerosus is a chronic inflammatory skin disorder that belongs to a group of autoimmune connective tissue diseases, localized within the skin and mucous membrane of the anogenital area. In the latter location, the focal atrophy of the mucosa is the most visible sign. Lesions may be accompanied by symptoms such as itching, pain, burning. The disease occurs more often in females. The etiology is not fully understood. Genetic, infectious, hormonal factors and autoimmune mechanisms are taken into consideration. Early diagnosis and appropriate treatment is important to avoid further complications. This review aims to analyze available literature on the treatment of this disease entity