Lichen sclerosus. Part 1. Guideline of the DGG, DGGG, OEGGG and SGGG (S3-Level, AWMF Registry No. 013-105, July 2025

Objective The aim of the German-language S3 guideline on lichen sclerosus (LS) is to provide an evidence- and consensus-based foundation for the diagnosis and management of this disease. The present publication offers a concise summary of the relevant content, focusing on genital LS in girls and women. This first part addresses, among other aspects, the definition, symptomatology, and diagnosis of LS, as well as its management during pregnancy. The separately published second part focuses on the treatment of LS. Methods The German-language, evidence- and consensus-based S3 guideline on LS was developed under the leadership of the German Society of Gynecology and Obstetrics (DGGG) and the German Dermatological Society (DDG), based on the European "EuroGuiDerm Guideline on Lichen Sclerosus." The interdisciplinary guideline panel included 24 experts from 16 professional societies and actively involved patient representatives in the development process. Recommendations LS is a chronic inflammatory skin disease with predominant manifestation in the anogenital region. It may be associated with pruritus, pain, sexual dysfunction, urinary symptoms, and constipation, although it can occasionally remain asymptomatic. Awareness of the broad spectrum of symptoms, as well as reversible and irreversible clinical signs, is essential to enable early diagnosis and appropriate treatment. Early and adequate therapy can not only alleviate symptoms but also reduce the risk of permanent damage and the development of associated carcinomas. During pregnancy, treatment with topical glucocorticoids should be continued as needed to control disease activity and prevent complications.