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

Area of Science:

• Dermatology
• Urology
• Gynecology

Background:

• Genital lichen sclerosus (GLS) is a chronic inflammatory skin condition with limited research on gender-specific differences.
• Previous studies have not specifically assessed gender-related variations in GLS clinical presentation, history, or disease course.

Purpose of the Study:

• To investigate and identify potential gender-related differences in the clinical features, patient history, and disease progression of genital lichen sclerosus.
• To analyze data from a large, mixed-gender patient cohort to understand these variations.

Main Methods:

• A multicenter, cross-sectional study involving 729 patients (53.8% female, 46.2% male) diagnosed with GLS.
• Data collected included clinical manifestations, symptom severity, extragenital involvement, prior treatments, diagnostic suspicion at referral, referring physician type, and development of genital squamous-cell carcinoma (SCC).

Main Results:

• Females reported more frequent and severe symptoms than males, with itching-related signs and extragenital involvement being more common.
• Pallor and scarring-sclerosis-atrophy were prevalent features irrespective of gender.
• Females more often received treatment before a definitive diagnosis, and 40% of all patients were initially misdiagnosed, with dermatologists showing higher diagnostic accuracy.

Conclusions:

• Significant gender-based differences exist in the clinical presentation and symptom profiles of genital lichen sclerosus.
• Despite characteristic features, a high rate of misdiagnosis at initial referral highlights challenges in timely and accurate GLS diagnosis.