ORIGINAL ARTICLE   Free access

Giornale Italiano di Dermatologia e Venereologia 2020 April;155(2):155-60

DOI: 10.23736/S0392-0488.17.05819-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Gender differences in genital lichen sclerosus: data from a multicenter Italian study on 729 consecutive cases

Annarosa VIRGILI ¹, Alessandro BORGHI ¹ ✉, Simone CAZZANIGA ^{2, 3}, Anna DI LANDRO ², Luigi NALDI ^{2, 4}, Sara MINGHETTI ¹, Maria T. FIERRO ⁵, Anna VERRONE ⁵, Marzia CAPRONI ⁶, Giuseppe MICALI ⁷, Valeria GASPARI ⁸, Manuela PAPINI ⁹, Vito DI LERNIA ¹⁰, Lerica GERMI ¹¹, Giampiero GIROLOMONI ¹², Anna BELLONI FORTINA ¹³, Serafinella P. CANNAVÒ ¹⁴, Roberta BILENCHI ¹⁵, Monica CORAZZA ¹ on behalf of the GLS Italian Study Group 

¹ Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; ² GISED Research Center, FROM Foundation, Bergamo, Italy; ³ Department of Dermatology, Inselspital University Hospital, Bern, Switzerland; ⁴ Unit of Dermatology, Papa Giovanni XXIII Hospital, Bergamo, Italy; ⁵ Department of Dermosyphilopathy #2, Città della Salute e della Scienza, Turin, Italy; ⁶ Division of Rare Skin Diseases and Immunopathology, Unit of Dermatology I, University of Florence, Florence, Italy; ⁷ Unit of Dermatology, G. Rodolico University Hospital, Vittorio Emanuele Polyclinic Hospital, Catania, Italy; ⁸ Unit of Dermatology, Department of Specialty, Diagnostic, and Experimental Medicine, University of Bologna, Bologna, Italy; ⁹ Division of Clinical Dermatology in Terni, Department of Surgery and Biomedicine, University of Perugia, Perugia, Italy; ¹⁰ Unit of Immunodermatology and Pediatric Dermatology, Arcispedale Santa Maria Nuova, Reggio Emilia Hospital and IRCCS, Reggio Emilia, Italy; ¹¹ Unit of Dermatology, San Bortolo Hospital, Vicenza, Italy; ¹² Unit of Dermatology, Department of Medicine, Verona University Hospital, Verona, Italy; ¹³ Unit of Clinical Dermatology, Department of Medicine, Padua University Hospital, Padua, Italy; ¹⁴ Unit of Dermatology, Department of Specialty Medicine, Gaetano Martino Polyclinic Hospital, Messina, Italy; ¹⁵ Unit of Dermatology, Department of Clinical Medicine and Applied Immunology, Siena University Hospital, Siena, Italy

BACKGROUND: Studies specifically conducted to assess gender differences in genital lichen sclerosus (GLS) are not available. This multicenter study aimed to identify possible gender-related differences on GLS clinical features, history and course, through collecting data from a large mixed-sex sample of patients.
METHODS: This was a cross-sectional study on 729 subjects (53.8% females, 46.2% males) affected with GLS, consecutively observed within a network of 15 Italian dermatology units. The following information was specifically collected: clinical features and severity of symptoms related to GLS, extragenital involvement, previous therapies, diagnostic suspicion at referral, type of referring physicians, development of genital squamous-cell carcinoma (SCC).
RESULTS: Females complained of symptoms more frequent and severe than men; pallor and scarring-sclerosis-atrophy were the most frequent features without gender differences; itching-related signs were more frequent in females than in males as well as extragenital involvement; prior to receiving a definitive diagnosis, females received treatment more frequently than males; 40% of patients were referred with a misdiagnosis; the highest rate of correct suspected diagnosis at referral came from dermatologists than from other physicians; duration of the disease was found to predispose to SCC development.
CONCLUSIONS: Our findings highlighted several gender differences on clinical presentation and symptom profile of GLS. In spite of some characteristic features, misdiagnosis at referrals was frequent.

KEY WORDS: Vulvar lichen sclerosus; Sex characteristics; Therapeutics; Squamous cell carcinoma