Managing vulvar lichen sclerosus in U.K. genitourinary medicine clinics
R R Jarvis1, J Yell, B P Goorney
1Department of Genitourinary Medicine, Hope Hospital, Salford, U.K. rani.jarvis@btinternet.com
Objective:
To survey genitourinary physicians in the United Kingdom on their approaches to the management of vulvar lichen sclerosus.
Study Design:
Questionnaire survey of United Kingdom genitourinary consultants.
Results:
Seventy-one percent of genitourinary physicians biopsy vulvar lichen sclerosus. For treatment, 78% of clinicians use a high-grade topical corticosteroid, such as 0.05% clobetasol propionate. Topical sex steroids are used by a minority of clinicians. Cases are followed by 80% of respondents. Having made the diagnosis of this condition, 30% of respondents refer the case to either a dermatologist or gynecologist for further management. Fifty-two percent refer only after treatment failure.
Conclusion:
Genitourinary physicians in the United Kingdom see and manage cases of vulvar lichen sclerosus in genitourinary medicine clinics. However, a majority of clinicians refer these cases at some stage. A coordinated and multispecialty approach between genitourinary physicians, dermatologists and gynecologists would provide coherent management of vulvar lichen sclerosus.
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