Ведение пациенток со склеротическим лихеном вульвы: диагностика и оптимизация терапии топическими глюкортикостероидами

1. Halonen P., Jakobsson M., Heikinheimo O., Gissler M., Pukkala E. Incidence of lichen sclerosus and subsequent causes of death: a nationwide Finnish register study. BJOG. 2020; 127(7): 814-9. https://dx.doi.org/10.1111/1471-0528.16175
2. Day T., Marzol A., Pagano R., Jaaback K., Scurry J. Clinicopathologic diagnosis of differentiated vulvar intraepithelial neoplasia and vulvar aberrant maturation. J. Low. Genit. Tract Dis. 2020; 24(4): 392-8. https://dx.doi.org/10.1097/LGT.0000000000000569
3. Prasad S., Black S.M., Zhu J.L., Sharma S., Jacobe H. Morphea patients with mucocutaneous involvement: a cross-sectional study from the Morphea in Adults and Children (MAC) cohort. J. Am. Acad. Dermatol. 2021; 85(1): 114-20. https://dx.doi.org/10.1016/j.jaad.2020.10.093
4. Vue N.C., Sassani J., Prairie B., Yin Y., Krivak T.C., Crafton S. et al. Clinical outcomes with utilization of high-potency topical steroids in patients with lichen sclerosus-associated vulvar cancer. Gynecol. Oncol. 2024; 187: 58-63. https://dx.doi.org/10.1016/j.ygyno.2024.05.003
5. Corazza M., Schettini N., Zedde P., Borghi A. Vulvar lichen sclerosus from pathophysiology to therapeutic approaches: Evidence and prospects. Biomedicines. 2021; 9(8): 950. https://dx.doi.org/10.3390/biomedicines9080950
6. Haefner H.K., Welch K.C., Rolston A.M., Koeppe E.S., Stoffel E.M., Kiel M.J. et al. Genomic profiling of vulvar lichen sclerosus patients shows possible pathogenetic disease mechanisms. J. Low Genit. Tract Dis. 2019; 23(3): 214-9. https://dx.doi.org/10.1097/LGT.0000000000000482
7. De Luca D.A., Papara C., Vorobyev A., Staiger H., Bieber K., Thaçi D. et al. Lichen sclerosus: the 2023 update. Front. Med. 2023; 10: 1106318. https://dx.doi.org/10.3389/fmed.2023.1106318
8. Pyle H.J., Evans J.C., Artami M., Raj P., Sridharan S., Arana C. et al. Assessment of the cutaneous hormone landscapes and microbiomes in vulvar lichen sclerosus. J. Invest. Dermatol. 2024; 144(8): 1808-16.e11. https://dx.doi.org/10.1016/j.jid.2024.01.027
9. Popa A., Dumitrascu M.C., Petca A., Petca R.C., Sandru F. Vulvar lichen sclerosus: navigating sex hormone dynamics and pioneering personalized treatment paradigm. J. Pers. Med. 2024; 14(1): 76. https://dx.doi.org/10.3390/jpm14010076
10. Desai M.K., Brinton R.D. Autoimmune disease in women: endocrine transition and risk across the lifespan. Front. Endocrinol. (Lausanne). 2019; 10: 265. https://dx.doi.org/10.3389/fendo.2019.00265
11. Gulin S.J., Lundin F., Seifert O. Comorbidity in patients with Lichen sclerosus: a retrospective cohort study. Eur. J. Med. Res. 2023; 28(1): 338. https://dx.doi.org/10.1186/s40001-023-01335-9
12. Liu L., Zhang Q., Chang J., Yang K. Causal association between diabetes, body mass index and lichen sclerosus: a bidirectional two-sample mendelian randomization analysis. Clin. Cosmet. Investig Dermatol. 2024; 17: 931-40. https://dx.doi.org/10.2147/CCID.S450399
13. Fan R., Leasure A.C., Maisha F.I., Little A.J., Cohen J.M. Depression and anxiety in patients with lichen sclerosus. JAMA Dermatol. 2022; 158(8): 953-4. https://dx.doi.org/10.1001/jamadermatol.2022.1964
14. Söderlund J.M., Hieta N.K., Kurki S.H., Orte K.J., Polo-Kantola P., Hietanen S.H. et al. Comorbidity of urogynecological and gastrointestinal disorders in female patients with lichen sclerosus. J. Low. Genit. Tract Dis. 2023; 27(2): 156-60. https://dx.doi.org/10.1097/LGT.0000000000000727
15. Vieira-Baptista P., Pérez-López F.R., López-Baena M.T., Stockdale C.K., Preti M., Bornstein J. Risk of development of vulvar cancer in women with lichen sclerosus or lichen planus: a systematic review. J. Low. Genit. Tract Dis. 2022; 26(3): 250-7. https://dx.doi.org/10.1097/LGT.0000000000000673
16. Furtado Y.L., Gieler C.R.C., Silveira F.A., Damian A., Almeida G. Childhood vulvar lichen sclerosus: the consequences of diagnostic delay. Brazilian J. Heal. Rev. 2024; 7(1): 2949-58. https://dx.doi.org/10.34119/bjhrv7n1-238
17. Krapf J.M., Smith A.B., Cigna S.T., Goldstein A.T. Presenting symptoms and diagnosis of vulvar lichen sclerosus in premenopausal women: a cross-sectional study. J. Low Genit. Tract Dis. 2022; 26(3): 271-5. https://dx.doi.org/10.1097/LGT.0000000000000679
18. Hodges K.R., Wiener C.E., Vyas A.S., Turrentine M.A. The female genital self-image scale in adult women with vulvar lichen sclerosus. J. Low Genit. Tract Dis. 2019; 23(3): 210-3. https://dx.doi.org/10.1097/LGT.0000000000000481
19. Ranum A., Pearson D.R. The impact of genital lichen sclerosus and lichen planus on quality of life: a review. Int. J. Women’s Dermatol. 2022; 8(3): e042. https://dx.doi.org/10.1097/JW9.0000000000000042
20. Rees S., Arnold S., Kherlopian A., Fischer G. Attitudes toward proactive topical corticosteroid use among women with vulval lichen sclerosus. J. Low. Genit. Tract Dis. 2024; 28(2): 183-8. https://dx.doi.org/10.1097/LGT.0000000000000791
21. Santhosh P., George M. Annular atrophic lichen planus: a review of the literature. Int. J. Dermatol. 2022; 61(10): 1213-7. https://dx.doi.org/10.1111/ijd.16038
22. Tam T., Crisp C.C., Hill A.M., Aldrich E., Ghodsi V., Yook E. et al. Utilization of a mirror during pelvic examinations: Does it improve the patient’s experience? Female Pelvic Med. Reconstr. Surg. 2021; 27(3): 208-13. https://dx.doi.org/10.1097/SPV.0000000000000975
23. Brandon A., Joshi T., Ahmed Z., Tahir M., Phung T., Pierce J.Y. et al. A rare presentation of lichen sclerosus involving the vaginal canal after radiation therapy: a case report and review of the literature. Cureus. 2023; 15(10): e47077. https://dx.doi.org/10.7759/cureus.47077
24. Mashoudy K.D., Tomlinson A.F., Kim S., Shivashankar V., Yosipovitch G., Fletcher M. Scratching the surface: a comprehensive guide to understanding and managing vulvovaginal itching. Am. J. Clin. Dermatol. 2025; 26(3): 361-78. https://dx.doi.org/10.1007/s40257-025-00939-7
25. Mahajan S.A., Dave J.S. Dermoscopic evaluation of extragenital lichen sclerosus et atrophicus. Dermatol. Pract. Concept. 2022; 12(3): e2022125. https://dx.doi.org/10.5826/dpc.1203a125
26. Lambova S.N., Müller-Ladner U. Nailfold capillaroscopy in systemic sclerosis – state of the art: the evolving knowledge about capillaroscopic abnormalities in systemic sclerosis. J. Scleroderma Relat. Disord. 2019; 4(3): 200-11. https://dx.doi.org/10.1177/2397198319833486
27. Erni B., Navarini A.A., Huang D., Schoetzau A., Kind A., Mueller S.M. Proposition of a severity scale for lichen sclerosus: the «Clinical lichen sclerosus score». Dermatol. Ther. 2021; 34(2): e14773. https://dx.doi.org/10.1111/dth.14773
28. Boero V., Liverani C.A., Brambilla M., Monti E., Tozzi R., Murina F. et al. The «cIV Classification», a new proposal for the architectural grading of vulvar lichen sclerosus. J. Low. Genit. Tract Dis. 2021; 25(4): 291-5. https://dx.doi.org/10.1097/LGT.0000000000000627
29. Kirtschig G., Cooper S., Aberer W., Jasaitiene D., Cooper S., Chi C.C. et al. Evidence-based (S3) guideline on (anogenital) lichen sclerosus. J. Eur. Acad. Dermatol. Venereol. 2017; 31(2): e81-3. https://dx.doi.org/10.1111/jdv.13740
30. Day T., Otton G., Dennerstein G., Tran H., Scurry J. Erosive lichen sclerosus - a clinicopathologic subtype. J. Low. Genit. Tract Dis. 2021; 25(3): 255-60. https://dx.doi.org/10.1097/LGT.0000000000000607
31. Lin A., Day T., Ius Y., Scurry J. Anogenital high-grade squamous intraepithelial lesion comorbid with vulvar lichen sclerosus and lichen planus. J. Low Genit. Tract Dis. 2020; 24(3): 311-6. https://dx.doi.org/10.1097/LGT.0000000000000540
32. Heller D.S., Day T., Allbritton J.I., Scurry J., Radici G., Welch K. et al. Diagnostic criteria for differentiated vulvar intraepithelial neoplasia and vulvar aberrant maturation. J. Low. Genit. Tract Dis. 2021; 25(1): 57-70. https://dx.doi.org/10.1097/LGT.0000000000000572
33. Borghi A., Flacco M.E., Zedde P., Toni G., Schettini N., Corazza M. Does clearance of vulvar lichen sclerosus after a corticosteroid treatment correspond to a decrease in disease-related burden? Results from a cohort study using pictorial representation of illness and self-measure and the dermatology life quality index. Dermatology. 2023; 239(1): 81-90. https://dx.doi.org/10.1159/000526257
34. Butkeviciute A., Ramanauskiene K., Kurapkiene V., Janulis V. Dermal penetration studies of potential phenolic compounds ex vivo and their antioxidant activity in vitro. Plants. 2022; 11(15): 1901. https://dx.doi.org/10.3390/plants11151901
35. Stacey S.K., McEleney M. Topical corticosteroids: choice and application. Am. Fam. Physician. 2021; 103(6): 337-43.
36. Аравийская Е.Р., Соколовский Е.В., Бахтина С.М., Пчелинцев М.В. Роль основы в глюкокортикостероидных препаратах: оптимальный состав и механизм действия. Вестник дерматологии и венерологии. 2010; 2: 64-70.
37. Белоусова Т.А., Каиль М.В. Терапевтические возможности наружных глюкокортикостероидов в современной клинической практике. Медицинский совет. 2020; 12: 36-45.
38. Pergialiotis V., Bellos I., Biliou E.C., Varnava P., Mitsopoulou D., Doumouchtsis S.K. An arm-based network meta-analysis on treatments for vulvar lichen sclerosus and a call for development of core outcome sets. Am. J. Obstet. Gynecol. 2020; 222(6): 542-50.e6. https://dx.doi.org/10.1016/j.ajog.2019.10.095
39. Соколова А.В., Аполихина И.А. Лечение склерозирующего лихена наружных половых органов у женщин: от стандартов к инновациям. Акушерство и гинекология. 2020; 7: 37-46.
40. Krapf J.M., Mitchell L., Holton M.A., Goldstein A.T. Vulvar lichen sclerosus: Current perspectives. Int. J. Womens Health. 2020; 12: 11-20. https://dx.doi.org/10.2147/IJWH.S191200
41. Tammaro A., Magri F., Iacovino C., Zollo V., Parisella F.R., Persechino S. Lichen sclerosus et atrophicus and allergic contact dermatitis: a significant association. J. Cosmet. Dermatol. 2019; 18(6): 1935-7. https://dx.doi.org/10.1111/jocd.12915
42. Lee A., Bradford J., Fischer G. Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women. JAMA Dermatol. 2015; 151(10): 1935-7. https://dx.doi.org/10.1001/jamadermatol.2015.0643
43. Corazza M., Toni G., Valpiani G., Morotti C., Borghi A. Does longer duration of corticosteroid treatment improve clearance in vulvar lichen sclerosus? Results from a single centre, comparative, open label study. Dermatol. Ther. 2021; 34(4): e14955. https://dx.doi.org/10.1111/dth.14955
44. Conforti C., Toffoli L., Giuffrida R., Retrosi C., Vezzoni R., Di Meo N. et al. An unusual presentation of genital herpes in a patient affected by lichen sclerosus et atrophicus: A case report and a combined treatment proposal. Dermatol. Ther. 2020; 33(2): e13239. https://dx.doi.org/10.1111/dth.13239
45. Papini M., Russo A., Simonetti O., Borghi A., Corazza M., Piaserico S. et al. Diagnosis and management of cutaneous and anogenital lichen sclerosus: recommendations from the Italian Society of Dermatology (SIDeMaST). Ital. J. Dermatol. Venereol. 2021; 156(5): 519-33. https://dx.doi.org/10.23736/S2784-8671.21.06764-X

Поступила 17.12.2025

Принята в печать 15.01.2026