The impact of anxiety on vulvar dermatological diseases: a systematic review

Vulvar inflammatory dermatoses, including lichen sclerosus, lichen planus, lichen simplex chronicus, and psoriasis, have been shown to impact mental health and quality of life.

We aimed to synthesize and evaluate the current literature regarding the association between anxiety and vulvar inflammatory dermatoses.

A comprehensive search was conducted using the Ovid MEDLINE, Embase, Cochrane, PubMed, PsycINFO, and Web of Science databases. Search terms included vulvar conditions (eg, "lichen sclerosus," "lichen planus," "lichen simplex chronicus," and "psoriasis") combined with anxiety-related terms ("anxiety," "anxious," and "mental health").

We included appropriate studies (eg, clinical trials, case-control studies, cohort studies, cross-sectional studies, or interview studies) directly addressing vulvar inflammatory dermatoses and anxiety. Studies without quantifiable anxiety outcomes or those that were reviews, protocols, commentaries, or abstracts were excluded. Two reviewers independently screened and resolved discrepancies by consensus.

A comprehensive search was conducted using the Ovid MEDLINE, Embase, Cochrane, PubMed, PsycINFO, and Web of Science databases. We included appropriate studies (eg, clinical trials, case-control studies, cohort studies, cross-sectional studies, or interview studies) directly addressing vulvar inflammatory dermatoses and anxiety.

Eighteen studies met inclusion criteria. Up to 52% of patients with vulvar inflammatory disease experience symptoms of anxiety that affect sexual functioning, activities of daily living, and plans for pregnancy. The severity of anxiety may be greater in newly diagnosed patients and younger women, while treatment serves as a protective factor. Treatment modalities, including topical corticosteroids, fat grafting, biologics, and platelet-rich plasma, were associated with reductions in anxiety symptoms concurrent with improvement in vulvar disease severity and quality-of-life measures.

There is a paucity of data reviewing vulvar dermatoses, specifically vulvar involvement of common dermatologic diseases such as lichen simplex chronicus and psoriasis.

The association between vulvar inflammatory diseases and anxiety may be multifaceted, with emerging evidence suggesting that vulvar disease may increase the risk of anxiety symptoms. Future efforts should focus on establishing targeted interventions that address both the dermatologic and psychological aspects of vulvar disease.