Burden of treatment in vulval lichen sclerosus

Lichen sclerosus (LS) is a chronic inflammatory dermatosis predominantly affecting the anogenital region, which can have significant impact on quality of life. Burden of treatment (BOT) is defined as the workload of healthcare experienced by patients and consequences on well-being. In this prospective study, 35 women with vulval LS completed a detailed Treatment Burden Questionnaire to assess their BOT. Nineteen (54.3%) achieved a score of 35 or less, signifying low BOT; ten (28.6%) between 36 and 65, signifying moderate BOT; and six (17.1%) above 65, signifying high BOT. Seven (20%) patients reported BOT scores of greater than 59, which has been designated as a cut-off for increased risk of treatment-related burnout. Higher BOT scores were moderately correlated with higher DLQI scores (r = 0.47, p < 0.01). BOT in LS is low for most patients, although a minority are at risk of treatment-related burnout. BOT should be considered when forming treatment guidelines for LS.