Cutaneous dysbiosis in girls with vulvar lichen sclerosus

Vulvar lichen sclerosus (VLS) is a chronic skin condition affecting the vulva, causing significant discomfort, but its etiology in prepubertal girls remains poorly understood. VLS presents with itching, irritation, and pain. Recent studies suggest that cutaneous dysbiosis might play a role in VLS. Our study aims to investigate differences in the vulvar skin microbiota among prepubertal girls with VLS, those with labial adhesions, and healthy controls, and to explore potential microbial links to VLS. We performed a comparative analysis of 16S ribosomal RNA (rRNA) sequences from vulvar skin samples of 18 girls with VLS, 15 girls with labial adhesions, and 11 healthy girls. Microbial diversity was assessed using α diversity, β diversity, and LEfSe, and functional microbial pathways were predicted. No differences were observed in α diversity among groups. However, β diversity analysis revealed significant differences in microbial composition (Jaccard, P = 0.001; unweighted UniFrac, P = 0.01). VLS patients had increased levels of Parvimonas and Fastidiosipila and differed from controls and labial adhesion cases in specific taxa. The NAD salvage pathway was notably associated with VLS. These findings suggest that cutaneous dysbiosis may contribute to VLS pathogenesis, providing insights into the microbial changes associated with the disease. Identifying microbial dysbiosis in VLS patients offers new perspectives on its pathogenesis and potential treatment strategies.

Cutaneous dysbiosis in vulvar lichen sclerosus (VLS) may play a key role in disease pathogenesis, especially when specific microbial imbalances persist in affected patients. However, most clinical evaluations focus on symptoms rather than microbial composition, risking missed opportunities for microbiome-targeted interventions. Thus, this study highlights the importance of microbiota surveillance as a potential tool for improving the diagnosis and treatment of VLS.